Effect of a combination of gliptin and metformin on serum vitamin B12, folic acid, and ferritin levels

Genc, Fevziye Turkoglu; Nalbant, Ahmet; Genc, Ahmed Cihad; Kaya, Tezcan

doi:10.1590/1806-9282.20230641

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…Xia et al augmented risk of all-cause mortality in these individuals, resonating with the plausible role of ferritin as not merely an iron storage marker but also a surrogate indicator of various pathophysiological processes. The intimate liaison between ferritin levels and all-cause mortality in stroke patients unveils a compelling narrative that interweaves paths of iron metabolism, inflammation, and oxidative stress, subsequently exerting a substantial impact on neurological vulnerability and systemic homeostasis (17,18). Ferritin, conventionally heralded for its role in iron storage, has progressively emerged as a biomarker that delineates intricate pathophysiological pathways and potentially foreshadows clinical outcomes in a myriad of conditions, including stroke (19,20).…”

Section: Discussionmentioning

confidence: 99%

The association between ferritin levels and all-cause mortality in stroke patients

Xia,

Liu,

Fang

et al. 2024

Front. Neurol.

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PurposeThe purpose of study was to describe the association between ferritin and all-cause mortality of cases with stroke.MethodsClinical data derived from Multiparameter Intelligent Monitoring in Intensive Care were analyzed. The primary endpoint was 30-day mortality. The potential prognostic roles of Ferritin L were analyzed by Cox proportional hazard models. The independent prognostic roles of Ferritin L in the cases were analyzed by smooth curve fitting.ResultsConcerning 30-day mortality, the HR (95% CI) for a high Ferritin (≥373) was 1.925 (1.298, 2.854; p = 0.00113), compared to a low ferritin (< 373). After adjusting for multiple confounders, the HR (95% CI) for a high Ferritin (≥373) was 1.782 (1.126, 2.820; p = 0.01367), compared to a low Ferritin (< 373). A non-linear association between Ferritin and 30-day mortality was found. Using recursive algorithm and two-piecewise linear regression model, inflection point (IP) was calculated, which was 2,204. On the left side of the IP, there was a positive relationship between Ferritin and 30-day mortality, and the effect size, 95% CI and p value were 1.0006 (1.0004, 1.0009) p < 0.0001, respectively. On the right of the IP, the effect size, 95% CI and p value were 1.0000 (1.0000, 1.0000) and 0.3107, respectively.ConclusionFerritin was associated with increased risk of stroke; it is important to further examine the association if the increased uric acid would increase the outcome of stroke in a longitudinal study. The non-linear relationship between Ferritin and all-cause mortality of stroke was observed. Ferritin was a risk factor for the outcome of stroke when ferritin was <2204.

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Section: Discussionmentioning

confidence: 99%

The association between ferritin levels and all-cause mortality in stroke patients

Xia,

Liu,

Fang

et al. 2024

Front. Neurol.

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Personalized approach in the management of women with heart failure with preserved ejection fraction and carbohydrate metabolism disorders

Petrovska,

Kostitska,

Petrovskyy

et al. 2025

Mìžnarodnij endokrinologìčnij žurnal

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Background. The progression of heart failure (HF) in individuals with carbohydrate metabolism disorders is one of the many fatal complications among comorbid conditions. It is found that the risk of developing HF in women with diabetes mellitus (DM) is five times higher than in those without it. Due to both heterogeneity and syntropy of etiopathogenetic mechanisms of occurrence, the prevalence of DM and HF is increasing in the world population, and delayed treatment potentiates a poor prognosis. The main task of the medical community is undoubtedly the early diagnosis of heart failure with preserved ejection fraction (HFpEF) and the prescription of justified pathogenetic treatment, especially for individuals with prediabetes/type 2 diabetes mellitus (T2DM). Therefore, the main strategy for the treatment of comorbid pathology is the use of patient-oriented approaches taking into account gender characteristics and the search for alternative ways to achieve glycemic goals safely in individuals with HFpEF and carbohydrate metabolism disorders. The purpose of the study was to examine the results of a 12-week course of treatment with metformin alone or a combination of metformin and dapagliflozin with an emphasis on the correction of functional iron deficiency in women with HFpEF and prediabetes/T2DM. Materials and methods. Sixty female individuals who met the study criteria were examined and divided into two groups: group I (n = 30) — HFpEF and prediabetes; group II (n = 30) — HFpEF and T2DM. Depending on the pathogenetic therapy, patients in both study groups were randomized to subgroup A (IA: n = 15; IIA: n = 15), who received metformin alone (at a daily dose of 500–2000 mg) and subgroup B (IB: n = 15; IIB: n = 15) — metformin (500–2000 mg/day) in combination with dapagliflozin (10 mg/day). According to the design of the scientific study, all patients at the beginning and after 12 weeks of therapy underwent assessment of basic anthropometric data, a set of laboratory examinations, clinical and instrumental diagnosis. Results. In the IB group, the high effectiveness of a 12-week course of pathogenetic therapy was confirmed according to the carbohydrate metabolism indicators (glycated hemoglobin (HbA1C): ∆–10.67 %, p < 0.001) with a significant increase in left ventricular ejection fraction (∆+7.73 %, p < 0.001) compared to the women receiving metformin alone (∆–1.53 %, p > 0.5). When using the studied treatments in individuals with HFpEF and prediabetes, it was confirmed a reliable normalization of glycemic control and a high chance (odds ratio 0.12, 95% confidence interval 0.011–1.339) of preventing the risk of T2DM. The effectiveness of additional prescription of dapagliflozin together with metformin in patients with HFpEF and carbohydrate metabolism disorders confirms the safe correction of functional iron deficiency with a significant increase of transferrin saturation (IB/IIB groups: ∆+38.51 %, p < 0.001/∆+ 29.59 %, p < 0.001); content of serum iron (IB/IIB groups: ∆+14.93 %, p < 0.001/∆+ 10.07 %, p < 0.5) and a tendency towards compensatory hypoferritinemia. On the background of a 12-week course of combination therapy (daily dose of metformin is 2000 mg, dapagliflozin is 10 mg), there was a comparable decrease in carbohydrate metabolism indicators in the IIB group (IIA/IIB groups: HbA1C after treatment: ∆–1.75 %/∆–10.67 %, p < 0.001, respectively) and an improvement of laboratory and instrumental parameters of HFpEF (IIA/IIB groups after treatment: NT-pro-BNP content: ∆–5.96 %, p < 0.05/∆–13.65 %, p < 0.001; left ventricular ejection fraction: ∆+1.38 %/∆+9.00 %, p < 0.001, respectively). Conclusions. The proposed personalized approaches to the treatment of women with HFpEF and prediabetes have prognosis-modifying effect on HF manifestations and effective glycemic control. Timely prescription of dapagliflozin together with metformin to women with HFpEF and carbohydrate metabolism disorders contributes to the safe correction of functional iron deficiency. As a result of receiving combined pathogenetic therapy, there was a comparable compensation of carbohydrate metabolism indicators and improvement of laboratory and instrumental signs of HF in patients with HFpEF and T2DM. These conclusions contribute to a better understanding of the therapeutic potential of dapagliflozin and the prevention of polypharmacy in comorbidity.

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Folic Acid Deficiency

Yingngam

2024

Advances in Medical Diagnosis, Treatment, and Care

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Folic acid deficiency, a critical global health issue, significantly impacts various population groups, particularly pregnant women and individuals with dietary restrictions. This chapter provides an in-depth analysis of folic acid deficiency, focusing on its epidemiology, causes, and clinical manifestations, including megaloblastic anemia and developmental complications. It underscores the crucial role of folic acid in human physiology, notably in DNA synthesis and repair. Additionally, the chapter discusses the complex nature of folic acid deficiency, which encompasses dietary inadequacies, malabsorption issues, and medication interactions, and confronts the challenges in diagnosis. Management strategies such as dietary modifications, supplementation, and public health policies, including fortification, are thoroughly examined. In conclusion, a multifaceted approach is vital for mitigating the impact of folic acid deficiency and enhancing health outcomes.

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Effect of a combination of gliptin and metformin on serum vitamin B12, folic acid, and ferritin levels

Cited by 3 publications

References 18 publications

The association between ferritin levels and all-cause mortality in stroke patients

The association between ferritin levels and all-cause mortality in stroke patients

Personalized approach in the management of women with heart failure with preserved ejection fraction and carbohydrate metabolism disorders

Folic Acid Deficiency

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