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. 2014 Sep 26:13:129.
doi: 10.1186/s12933-014-0129-4.

Vitamin B12 deficiency is associated with adverse lipid profile in Europeans and Indians with type 2 diabetes

Antonysunil Adaikalakoteswari, Ramamurthy Jayashri, Nithya Sukumar, Hema Venkataraman, Rajendra Pradeepa, Kuppan Gokulakrishnan, Ranjit Mohan Anjana, Philip G McTernan, Gyanendra Tripathi, Vinod Patel, Sudhesh Kumar, Viswanathan Mohan, Ponnusamy Saravanan

Vitamin B12 deficiency is associated with adverse lipid profile in Europeans and Indians with type 2 diabetes

Antonysunil Adaikalakoteswari et al. Cardiovasc Diabetol. .

Abstract

Background: Metformin, a standard therapy in type 2 diabetes, reduces vitamin B12 levels. Studies linking low vitamin B12 levels and cardiovascular disease are equivocal and suggest improving B12 levels may help in primary prevention. The role of vitamin B12 deficiency on cardiovascular risk factors, especially in type 2 diabetes has not been explored. The aim of this study is to investigate whether vitamin B12 deficiency in type 2 diabetes patients is associated with cardiovascular risk factors in two different ethnic groups in UK and India.

Methods: Type 2 diabetes patients from two secondary care diabetic centres (Europeans - UK and Indians - India) were studied. Serum vitamin B12, folate and biochemical parameters were measured.

Results: The prevalence rates of vitamin B12 deficiency (<191 ng/L) were 27% and 12% in Europeans and Indians, respectively and higher in metformin treated type 2 diabetes patients. In linear regression analysis, after adjusting for all likely confounding factors, vitamin B12 independently associated with triglycerides in both the populations and cholesterol/HDL ratio in Indians. Logistic regression showed type 2 diabetes patients with vitamin B12 deficiency were at significantly higher odds of having coexisting coronary artery disease (CAD) in Europeans with similar but non-significant trend in Indians, after adjusting for all likely confounding factors.

Conclusions: The prevalence of vitamin B12 deficiency is common in type 2 diabetes patients and is associated with adverse lipid parameters. Type 2 diabetes management guidelines should include the recommendation for regular testing for B12 levels, especially for those on metformin.

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Figures

Figure 1
Figure 1
Regression of Vitamin B12 with (a) Triglycerides in Europeans, (b) Triglycerides in Indians, (c) Cholesterol: HDL ratio in Europeans and (d) Cholesterol: HDL ratio in Indians. *Log-transformed for statistical comparisons. Model included vitamin B12, age, BMI, sex, duration of diabetes, HbA1C, smoking, use of metformin, statin & aspirin.
See this image and copyright information in PMC

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