Metformin lowers serum cobalamin without changing other markers of cobalamin status: a study on women with polycystic ovary syndrome

Treatment with the anti-diabetic drug metformin is followed by a decline in plasma cobalamin, but it is unsettled whether this denotes an impaired cobalamin status. This study has explored changes in the markers of cobalamin status in women with Polycystic Ovary Syndrome treated with metformin (1.5-...

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Bibliographic Details
Published in:Nutrients 2013-07, Vol.5 (7), p.2475-2482
Main Authors: Greibe, Eva, Trolle, Birgitta, Bor, Mustafa V, Lauszus, Finn F, Nexo, Ebba
Format: Article
Language:English
Subjects:
Adolescent
Adult
Antidiabetics
Biochemistry
Biomarkers - blood
Blood
Body Mass Index
Chronic illnesses
cobalamin
Cohort Studies
Cross-Over Studies
Diabetes
Female
Gynecology
haptocorrin
Hemoglobin
holotranscobalamin
Humans
Hypoglycemic Agents - administration & dosage
Metabolism
metformin
Metformin - administration & dosage
Middle Aged
Obstetrics
Ovaries
Polycystic Ovary Syndrome
Polycystic Ovary Syndrome - blood
Polycystic Ovary Syndrome - drug therapy
Vitamin B 12 - blood
vitamin B12
Vitamin deficiency
Womens health
Young Adult
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Summary:Treatment with the anti-diabetic drug metformin is followed by a decline in plasma cobalamin, but it is unsettled whether this denotes an impaired cobalamin status. This study has explored changes in the markers of cobalamin status in women with Polycystic Ovary Syndrome treated with metformin (1.5-2.5 g per day) (n = 29) or placebo (n = 23) for six months. Serum samples were collected before and after two, four, and six months of treatment. We found serum cobalamin to decline and reach significant lower levels after six months of treatment (p = 0.003). Despite the decline in serum cobalamin, we observed no reductions in the physiological active part of cobalamin bound to transcobalamin (holotranscobalamin), or increase in the metabolic marker of cobalamin status, methylmalonic acid. Instead, the non-functional part of circulating cobalamin bound to haptocorrin declined (p = 0.0009). Our results have two implications: The data questions whether metformin treatment induces an impaired cobalamin status in PCOS patients, and further suggests that serum cobalamin is a futile marker for judging cobalamin status in metformin-treated patients.
ISSN:2072-6643
2072-6643
DOI:10.3390/nu5072475