Multivitamin Use and Serum Vitamin B12 Concentrations in Older-Adult Metformin Users in REGARDS, 2003-2007

Metformin, an insulin-sensitizing drug, is a first line treatment for type 2 diabetes. Long-term use of metformin has been associated with subsequent reductions in vitamin B12 concentrations. The objective of our study was to determine whether metformin use is associated with lower serum vitamin B12...

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Bibliographic Details
Published in:PloS one 2016-08, Vol.11 (8), p.e0160802
Main Authors: Kancherla, Vijaya, Garn, Joshua V, Zakai, Neil A, Williamson, Rebecca S, Cashion, Winn T, Odewole, Oluwaseun, Judd, Suzanne E, Oakley, Jr, Godfrey P
Format: Article
Language:English
Subjects:
Adult
Adults
Aged
Analysis
Antidiabetics
Biology and Life Sciences
Blood serum
Case-Control Studies
Confidence intervals
Cyanocobalamin
Diabetes
Diabetes mellitus
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - drug therapy
Dietary supplements
Dietary Supplements - statistics & numerical data
Dosage and administration
Drug dosages
Drug therapy
Epidemiology
Family medical history
Female
Health aspects
Homocysteine
Humans
Hypoglycemic Agents - adverse effects
Insulin
Male
Medicine and Health Sciences
Metformin
Metformin - adverse effects
Middle Aged
Multivitamins
Nutrition
Older people
People and Places
Peripheral neuropathy
Physical Sciences
Population
Public health
Racial differences
Regression analysis
Regression models
Risk factors
Sensitizing
Statistical analysis
Stroke
Studies
Time Factors
Type 2 diabetes
Vitamin B 12 - blood
Vitamin B 12 Deficiency - chemically induced
Vitamin B12
Vitamin deficiency
Vitamins
Vitamins - administration & dosage
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Summary:Metformin, an insulin-sensitizing drug, is a first line treatment for type 2 diabetes. Long-term use of metformin has been associated with subsequent reductions in vitamin B12 concentrations. The objective of our study was to determine whether metformin use is associated with lower serum vitamin B12 concentrations in older adults, and whether concurrent use of multivitamins modifies this association. We examined 2,510 participants aged 50 years and over, participating in the national population-based Reasons for Geographic And Racial Differences in Stroke (REGARDS) Study. Multivariable linear and logistic regression models were used to assess associations between multivitamin use and serum vitamin B12 concentrations. We estimated adjusted odds ratios (aOR)s and confidence intervals (CI)s. Results were stratified by three metformin/diabetes sub-groups: 1) participants with diabetes who were metformin users; 2) participants with diabetes who were not metformin users; and 3) participants without diabetes. We found that diabetic metformin users had significantly lower geometric mean serum B12 concentrations (409 pmol/L) than the group with diabetes not taking metformin (485 pmol/L; P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0160802