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Vitamin B 12 Deficiency in the Elderly using Metformin Long Term: Prevalence and Relationship to Putative Risk Factors
Author(s) -
Sorich Wassana,
Stranks Steve N,
Kowalski Stefan R,
Kuruvila Manoj T,
Sorich Michael J
Publication year - 2008
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2008.tb00814.x
Subject(s) - medicine , metformin , vitamin d deficiency , vitamin d and neurology , vitamin , gastroenterology , endocrinology , diabetes mellitus
Aim To determine the prevalence of vitamin B 12 deficiency in elderly patients using metformin long term and to assess putative risk factors for reduced vitamin B 12 concentrations. Method Patients using metformin for more than 2 years admitted to or reviewed in the Repatriation General Hospital from June to December 2006 were enrolled in this cross‐sectional study. The prevalence of vitamin B 12 deficiency and the association between vitamin B 12 deficiency and putative risk factors were determined. Results 60 patients were recruited. Of the 53 patients not taking vitamin B 12 supplements, 8 (15%; 95%CI 7.2–28.1) were vitamin B 12 deficient (83–148 pmol/L). 7 patients taking vitamin B 12 supplements had statistically significantly higher serum vitamin B 12 concentrations and decreased B 12 deficiency. Daily metformin dose was associated with a statistically significant negative correlation with vitamin B 12 concentration and was statistically higher in vitamin B 12 ‐deficient patients. Duration of metformin therapy, age and use of proton pump inhibitors or calcium supplements were not statistically significantly associated with vitamin B 12 concentration or deficiency. Conclusion Elderly patients taking metformin should be monitored for vitamin B 12 status, especially those on high doses of metformin. Vitamin B 12 , but not calcium, supplements should be considered to prevent or correct deficiency.