Opportunistic Screening of Vitamin B12 Deficiency in IT Professionals Presenting for Routine Health Check-up

Ingole, Jitendra; Patel, Rishi Devilal; Ingole, Sonali; Pandave, Harshal Tukaram

doi:10.7860/jcdr/2015/16191.6866

Cited by 10 publications

(13 citation statements)

References 13 publications

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“…In the predominantly vegetarian Indians who eat only small amounts of animal-derived foods [33,43], hyperhomocysteinemia is usually associated with vitamin B12 deficiency [44][45][46]. A study from India found that vitamin B12 supplementation but not folic acid was associated with lower plasma total homocysteine concentration [4].…”

Section: Discussionmentioning

confidence: 99%

Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India

et al. 2017

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Background: Low folate and vitamin B12 levels have negative effect on pregnancy outcomes but there is paucity of data on their levels among Indian women. Ferritin and haemoglobin are associated with maternal mortality and low birth-weight. Our aim was to estimate the prevalence of deficiency of serum folate and vitamin B12, and low levels of serum ferritin and blood haemoglobin among women of childbearing age from a rural population of South India. Methods: We conducted a community-based cross-sectional study among 15-35 year women in a rural district. We used multistage stratified random sampling. Trained staff interviewed women to collect socio-demographic information and draw blood samples. We analysed samples for serum folate, vitamin B12, ferritin and blood haemoglobin levels and computed means and medians. We computed the proportion of deficiency based on cut-offs recommended by WHO. We examined the association of levels with age, parity and current pregnancy or breastfeeding by multi-variable regression using Stata 13.0. Results: We recruited 979 women. One-fifth (185, 19%) were pregnant and one-fifth (196, 20%)were breastfeeding. Median serum folate levels were 2.5 ng/ml (IQR, 1.2-4.8), median vitamin B12 levels were 228.0 pg/ml (IQR, 121 -390), median ferritin levels were 13.0 μg/l (IQR, 6.0 -20.0) and median blood haemoglobin levels were 12.1 mg/dl (IQR, 10.7 -13.6). Low levels of serum folate, vitamin B12, ferritin and haemoglobin were found in 57% (95% CI, 54-60%), 44% (95% CI, 41-48%), 46% (95% CI, 43-49%) and 28% (95% CI, 25-31%) respectively. Women with folic acid deficiency had two times higher prevalence of having vitamin B12 deficiency. In adjusted regression analysis folate levels were lower in older and breastfeeding women, but not associated with parity and were higher among pregnant women. Similar associations were not found with Vitamin B12 deficiency. Ferritin levels were higher in older women; but not associated with parity, pregnancy or breastfeeding. Haemoglobin levels were lower in pregnant and breastfeeding women. Conclusion: Our findings suggest that folic acid, vitamin B12 and iron deficiency are important public health problems in India. We observed that half of the women of childbearing age were deficient in these nutrients. Folic acid and vitamin B12 deficiencies co-exist and should be supplemented together.

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Section: Discussionmentioning

confidence: 99%

Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India

et al. 2017

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“…[123456] Without adjusting for duration of diabetes, there was neither a significant difference in serum Vitamin B12 levels nor in the prevalence of Vitamin B12 deficiency. However, the prevalence of Vitamin B12 deficiency in patients on metformin in our study is higher than that reported in Western literature.…”

Section: Discussionmentioning

confidence: 99%

Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study

Raizada

Jyotsna

Sreenivas

et al. 2017

Indian J Endocr Metab

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Context:There are limited data about the effect of metformin use on serum Vitamin B12 levels in type 2 diabetes patients from India.Aims:We studied serum Vitamin B12 levels in patients with type 2 diabetes mellitus who were receiving metformin and compared them to those never treated with metformin.Subjects and Methods:A total of 183 patients (“metformin” group 121, “no metformin” group 63) of type 2 diabetes from the endocrinology clinic of a tertiary care center in North India were studied. Serum Vitamin B12 levels were measured in all patients. Diabetic neuropathy symptom score (DNS) and diabetic neuropathy examination score (DNE) were used to assess peripheral neuropathy while hemoglobin and mean corpuscular volume (MCV) were used to assess anemia.Results:The serum Vitamin B12 levels were 267.7 ± 194.4 pmol/l in metformin group and 275.1 ± 197.2 pmol/l in the no metformin group (P = 0.78). When adjusted for duration of diabetes, metformin use was associated with a 87.7 ± 37.7 pmol/l (95% confidence interval [CI], −162.1–−3.3, P = 0.02) lower serum Vitamin B12 levels. No significant increase in the prevalence of neuropathy (DNS and DNE scores), anemia, or MCV was found in the Vitamin B12 deficient patients (levels <150 pmol/l) as compared to patients with normal Vitamin B12. However, serum Vitamin B12 levels for the entire cohort were higher by 12.2 ± 3.0 pmol/l (95% CI 6.4–18.0, P < 0.001) for every 1 year increase in the duration of diabetes.Conclusions:Metformin use was associated with a lower serum Vitamin B12 levels when adjusted for duration of diabetes. Increasing duration of diabetes was associated with higher serum Vitamin B12 levels.

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“…4 This was not surprising considering that the prevalence of Vitamin B12 in the apparently healthy populations in India had been reported to be as high as 33.3%-67%. 7,8 A predominantly vegetarian diet could be one of the causes of higher prevalence of Vitamin B12 deficiency in India. 7 The mean age in the present study was 57.53±11.86 years in group A and 55.37±13.93 years in Group B.…”

Section: Discussionmentioning

confidence: 99%

“…7,8 A predominantly vegetarian diet could be one of the causes of higher prevalence of Vitamin B12 deficiency in India. 7 The mean age in the present study was 57.53±11.86 years in group A and 55.37±13.93 years in Group B. The difference between these two values was non-significant.…”

Section: Discussionmentioning

confidence: 99%

Correlation of vitamin B12 deficiency with metformin therapy in type 2 diabetes mellitus patients

2020

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Background: Diabetes mellitus is an endocrine and metabolic disorder, characterized by hyperglycemia. Metformin is the first line pharmacotherapy recommended by ADA. It has been recognized that metformin use is associated with serum vitamin B12 deficiency. The objective of this study is to determine the prevalence of serum vitamin B12 deficiency among Indian patients with type 2 diabetes mellitus on metformin therapy compared to those who are not on metformin.Methods: Here, 90 patients of type 2 diabetes mellitus of both sexes were included in this cross-sectional study conducted from January 2018 to August 2019 in SGRDIMSR, Sri Amritsar. They were divided into two groups; Group A of 60 subjects of type 2 diabetes mellitus on metformin therapy >1 year and group B of 30 subjects of type 2 diabetes mellitus not on metformin or had stopped taking metformin 6 months back. Serum vitamin B12 levels were measured using a Chemiluminescence method. Data was statistically analysed.Results: The serum vitamin B12 levels were 190.02±90.75 pmol/l in group A (metformin users) and 586.9±243.69 pmol/l in group B (not metformin users) (p value=0.002). A significant negative correlation existed between the serum vitamin B12 and duration and dose of metformin use (r꞊ -0.676) and (r -0.855) by using Pearson’s correlation coefficient in group A.Conclusions: Metformin is associated with decrease in serum vitamin B12 levels. Annual screening of serum vitamin B12 is recommended for patients of type 2 diabetes mellitus who are on metformin therapy for longer duration and /or in higher doses.

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Opportunistic Screening of Vitamin B12 Deficiency in IT Professionals Presenting for Routine Health Check-up

Cited by 10 publications

References 13 publications

Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India

Folate, vitamin B12, ferritin and haemoglobin levels among women of childbearing age from a rural district in South India

Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study

Correlation of vitamin B12 deficiency with metformin therapy in type 2 diabetes mellitus patients

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