Effect of metformin therapy on vitamin D and vitamin B12 levels in patients with type 2 diabetes mellitus. Journal Article

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Authors: Kos, E.; Liszek, M. J.; Emanuele, M. A.; Durazo-Arvizu, R; Camacho, P
Article Title: Effect of metformin therapy on vitamin D and vitamin B12 levels in patients with type 2 diabetes mellitus.
Abstract: OBJECTIVE: To determine the effect of metformin on 25-hydroxyvitamin D [25(OH)D] and vitamin B12 levels in patients with type 2 diabetes mellitus. METHODS: We performed a retrospective review of medical records of patients treated between 2003 and 2009 at Loyola University Medical Center, Maywood, Illinois, in both ambulatory primary care and endocrinology clinics. The study cohort consisted of 706 patients with type 2 diabetes mellitus who were 20 to 93 years old (mean age, 63 +/- 13) and had a mean body mass index of 33.1 kg/m2. Of these patients, 42% were treated with metformin, and 34% had been diagnosed with osteoporosis or osteopenia. RESULTS: Patients taking metformin had statistically significant lower vitamin B12 levels than those not receiving metformin (P.0001; 95% confidence interval [CI] = -220 to -84 pg/mL). No statistically significant difference was found between users and nonusers of metformin in regard to 25(OH)D levels when adjusted for variables (P = .297; 95% CI for mean difference = -0.7 to 2.2 ng/mL). Metformin use did not adversely affect successful treatment of vitamin D deficiency in this patient population as a whole, nor did it affect the subgroup with osteoporosis (P = .956). The patients with osteoporosis had statistically significant lower baseline 25(OH)D levels in comparison with those without osteoporosis, when adjustments were made for all variables (P = .003; 95% CI = 0.7 to 3.5 ng/mL). CONCLUSION: This study confirms the higher prevalence of vitamin B12 deficiency in metformin-treated patients with type 2 diabetes than in those not treated with metformin. This study also suggests that vitamin D deficiency is not a clinical concern among metformin-treated patients with type 2 diabetes and that metformin does not negatively affect treatment of vitamin D deficiency in these patients.
Journal Title: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Volume: 18
Issue: 2
ISSN: 1934-2403; 1530-891X
Publisher: Unknown  
Journal Place: United States
Date Published: 2012
Start Page: 179
End Page: 184
Language: English
DOI/URL:

http://ovidsp.ovid.com/ovidweb.cgi?T=JS=Y=N=fulltext=medl=21940283

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Notes: ID: 12475; Record Owner: From MEDLINE, a database of the U.S. National Library of Medicine.; Status: MEDLINE; Publishing Model: Journal available in: Print Citation processed from: Internet; NLM Journal Code: 9607439, dy1; CAS Registry/EC Number/Name of Substance: 0 (Hypoglycemic Agents). 19356-17-3 (Calcifediol). 21343-40-8 (25-Hydroxyvitamin D 2). 657-24-9 (Metformin). 68-19-9 (Vitamin B 12).; Entry Date: 20120808