Metformin, B12 and Homocysteine Levels: The Plausible Cause or Effect?

Musarrat, Kashif; Kalathil, Dhanya; Varughese, George

doi:10.1016/s0929-6646(08)60160-6

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…On the other hand, it can also cause endothelial cell aging, reduce the synthesis of nitric oxide (NO), and increase secretion of vascular pseudohemophilia factor (VWF) and other cells. Hcy can also activate protein kinase C, promoting the expression of proto oncogene c-fos and c-myb in vascular smooth muscle cells [10, 11, 12]. Therefore, Hcy may be induced by oxidative stress and endothelial damage.…”

Section: Discussionmentioning

confidence: 99%

Metformin can alleviate the symptom of patient with diabetic nephropathy through reducing the serum level of Hcy and IL-33

et al. 2019

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AbstractBackgroundInterleukin-33 (IL-33) and homocysteine (Hcy) were found to be up-regulated in patients with diabetic nephropathy (DN), and the present study aimed to investigate whether metformin (MT) can influence the serum levels of IL-33 and Hcy in patients with DN.MethodsSixty patients with type 2 diabetes mellitus (DM) were divided into DM group (albumin: Alb <20 mg/L), DN group (Alb >20mg/L), and DN+ MT treatment group, with 20 cases in each group. Patients in each group were treated with insulin for 3 months, and patients in DN+MT group was treated with insulin+MT for 3 months. The serum levels of IL-33, urinary microalbumin excretion rate (UAE), body mass index (BMI), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), creatinine (Cr), cystatin C (CysC) and Hcy were measured before and after medication. Twenty normal subjects were involved as control.ResultsBMI, Hcy and TC were reduced and HDL-C was increased of patients had been treated with metformin and insulin. UAE, Cr, Ccr and CysC had no differences before and after treatment. The serum level of IL-33 significantly up-regulated in patients with DN, and MT treatment significantly decreased the serum level of IL-33 in patients with DN.ConclusionMetformin could alleviate the symptom of patient with DN through decreasing the serum level of IL-33 and Hcy.

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Section: Discussionmentioning

confidence: 99%

Metformin can alleviate the symptom of patient with diabetic nephropathy through reducing the serum level of Hcy and IL-33

et al. 2019

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“…La HipHomCis puede ser un estandarte en otras entidades como el hipotiroidismo 127,128 y explicar el mayor riesgo cardiovascular en escenarios como el tabaquismo, 129,130 la alta ingesta de café (cafeína y otras metilxantinas) 131 , los andrógenos en el sexo masculino y la terapia con estas hormonas 132,133 , la administración de ciertos fármacos hipolipemiantes como ácido nicotínico y fibratos 134 , y el uso de hipoglicemiantes orales como la metformina. 135 Ciertos antihipertensivos/ hipotensores tienen efectos contrarios, así los diuréticos causan HipHomCis mientras los betabloqueadores y los inhibidores de la enzima convertidora de angiotensina son hipohomocisteinantes. 136 De ahí que la farmacoterapia de este trastorno sea un área interesante para emplear diversas herramientas como la dieta y la suplementación con barredores de HomCis como la colina, la betaína y la creatina.…”

Section: Conclusionesunclassified

Biología, patobiología y bioclínica de la homocisteína eh la especie humana

García¹

2010

Repert. Med. Cir.

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La homocistinuria fue descrita en 19a2 en niños con dificultades de aprendizaje y en 19a9 McCully informó la evidencia en autopsias de trombosis arterial eztensa y aterosclerosis en niños con elevadas concentraciones de homocisteína plasmática y homocistinuria. La homocisteína, un aminoácido de azufre, es un metabolito intermedio de la metionina, y sobre la base de estos hallazgos bioquímicos, ellos propusieron que la homocisteína plasmática elevada puede causar lesión neural y enfermedad vascular aterosclerótica. Hoy se considera un factor de riesgo independiente para esta última. La hiperhomocistinemia leve es bastante prevalente en la población general. Puede deberse a defectos genéticos en las enzimas que participan en el metabolismo de la homocisteína, carencias nutricionales de vitaminas y cofactores, ciertos medicamentos, ingesta rica en metionina o enfermedad renal. La alta concentración puede reducirse con folato, y es así que la suplementación vitamínica ha sido propuesta en individuos con hiperhomocistinemia con el fin de reducir su riesgo de enfermedad cardiovascular. En este artículo hacemos una revisión de la biología, la patobiología y la bioclínica del metabolismo de la homocisteína.

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“…However there have been several theories into the exact mode of this malabsorption (Musarrat, Kalathil, & Varughese, 2008;Nervo et al, 2011).…”

Section: -Metformin Induced Vitamin B12 Deficiencymentioning

confidence: 99%

The prevalence and treatment of metformin associated Vitamin B12 deficiency in patients with type 2 Diabetes Mellitus in New Zealand

Haeusler¹

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<p>With an ever increasing incidence of type 2 diabetes in the New Zealand population, continual assessment must be made to ensure the ongoing evaluation of treatment options to ensure patient care is not compromised. Previous research has shown higher prevalence of Vitamin B12 deficiency in patients with type 2 Diabetes Mellitus who have had long term metformin treatment. An investigation into patients attending secondary care clinics at the Diabetes Clinic at Wellington Regional Hospital as well as primary health care patients has explored the prevalence of this interaction in the New Zealand population as well as assessed the factors that may contributed to such an effect. It was found that there is a high prevalence of decreased serum Vitamin B12 level in patients with type 2 Diabetes exposed to metformin treatment. Factors such as age and ethnicity were seen to be key predictors of this interaction and have shown a unique view of how the population of New Zealand may be affected. Treatment of decreased serum Vitamin B12 levels was seen to be effective through both sublingual and intramuscular methods with variations in both short and long term effects. The use of sublingual treatment administration of Vitamin B12 supplementation is unique in the scope of metformin induced Vitamin B12 deficiency and has shown potential to be a therapeutic route for patients affected by such an interactions. Current views on the interaction between metformin and serum Vitamin B12 levels are currently under debate in regards to physiological relevance and clinical outcomes. This paper provides a first look at the effect of this interaction in a New Zealand population and evaluates treatment options for such. Furthermore a proposal is made for an alternate mechanism of metformin action on Vitamin B12 levels which may aid understanding of observations made in both in this paper and previous studies.</p>

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Metformin, B12 and Homocysteine Levels: The Plausible Cause or Effect?

Cited by 4 publications

References 8 publications

Metformin can alleviate the symptom of patient with diabetic nephropathy through reducing the serum level of Hcy and IL-33

Metformin can alleviate the symptom of patient with diabetic nephropathy through reducing the serum level of Hcy and IL-33

Biología, patobiología y bioclínica de la homocisteína eh la especie humana

The prevalence and treatment of metformin associated Vitamin B12 deficiency in patients with type 2 Diabetes Mellitus in New Zealand

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