title: Vitamin B12 deficiency is associated with adverse lipid profile in Europeans and Indians with type 2 diabetes.
abstract: BACKGROUND
  Metformin, a standard therapy in type 2 diabetes, reduces vitamin B12 levels. Studies linking low vitamin B12 levels and cardiovascular disease are equivocal and suggest improving B12 levels may help in primary prevention. The role of vitamin B12 deficiency on cardiovascular risk factors, especially in type 2 diabetes has not been explored. The aim of this study is to investigate whether vitamin B12 deficiency in type 2 diabetes patients is associated with cardiovascular risk factors in two different ethnic groups in UK and India.
  
  
  METHODS
  Type 2 diabetes patients from two secondary care diabetic centres (Europeans - UK and Indians - India) were studied. Serum vitamin B12, folate and biochemical parameters were measured.
  
  
  RESULTS
  The prevalence rates of vitamin B12 deficiency (<191 ng/L) were 27% and 12% in Europeans and Indians, respectively and higher in metformin treated type 2 diabetes patients. In linear regression analysis, after adjusting for all likely confounding factors, vitamin B12 independently associated with triglycerides in both the populations and cholesterol/HDL ratio in Indians. Logistic regression showed type 2 diabetes patients with vitamin B12 deficiency were at significantly higher odds of having coexisting coronary artery disease (CAD) in Europeans with similar but non-significant trend in Indians, after adjusting for all likely confounding factors.
  
  
  CONCLUSIONS
  The prevalence of vitamin B12 deficiency is common in type 2 diabetes patients and is associated with adverse lipid parameters. Type 2 diabetes management guidelines should include the recommendation for regular testing for B12 levels, especially for those on metformin.
authors.forename: Antonysunil
authors.initials: A
authors.lastname: Adaikalakoteswari
authors.forename: Ramamurthy
authors.initials: R
authors.lastname: Jayashri
authors.forename: Nithya
authors.initials: N
authors.lastname: Sukumar
authors.forename: Hema
authors.initials: H
authors.lastname: Venkataraman
authors.forename: Rajendra
authors.initials: R
authors.lastname: Pradeepa
authors.forename: Kuppan
authors.initials: K
authors.lastname: Gokulakrishnan
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.forename: Philip G
authors.initials: PG
authors.lastname: McTernan
authors.forename: Gyanendra
authors.initials: G
authors.lastname: Tripathi
authors.forename: Vinod
authors.initials: V
authors.lastname: Patel
authors.forename: Sudhesh
authors.initials: S
authors.lastname: Kumar
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
authors.forename: Ponnusamy
authors.initials: P
authors.lastname: Saravanan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000235:genetics / Q000378:metabolism*; D005060:Europe; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007194:India; D050356:Lipid Metabolism; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014806:Vitamin B 12 Deficiency / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism*
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin