The role of Helicobacter pylori in vitamin-B12 deficiency due to metformin use
Abstract
BACKGROUND: Metformin is widely used for the treatment of type-2 diabetes (T2D) but was shown to cause vitamin-B12 deficiency. H pylori infection was also suggested to cause vitamin-B12 deficiency. This study aimed to elucidate the relationships in this triad by investigating vitamin-B12 deficiency and H pylori infection in T2D patients using metformin.
MATERIALS AND METHODS: This descriptive cross-sectional study recruited T2D patients using metformin from a primary care center and examined their socioeconomic status, accompanying complaints, medication use, and hemogram parameters such as serum vitamin B12 , calcium, and hemoglobin. The presence of H pylori infection was determined through stool antigen test.
RESULTS: Study included 421 T2D patients on metformin regimen: 213 (50.6%) males and 208 (49.4%) females. The mean duration of diabetes was 9.88 ± 7.32 years, and the total metformin dose was 1925.5 ± 236.7 mg/d. Almost half of the participants (n = 199, 47.3%) had H pylori infection, and more than half (n = 222, 52.7%) had vitamin-B12 deficiency. The rate of vitamin-B12 deficiency was significantly higher among those with H pylori infection. No significant relationship was found between the daily metformin dose and vitamin-B12 deficiency.
CONCLUSIONS: This study supported the role of H pylori infection in vitamin-B12 deficiency. However, the effects of increased metformin dose and H pylori infection on vitamin-B12 levels were not additive. It is recommended that…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 421 participants or records.
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