Perm Medical JournalPerm Medical Journal0136-14492687-1408Eco-Vector4896610.17816/pmj3745-10Research ArticlePresence and absence of carbohydrate metabolism disorders as a factor influencing development of vitamin B12 deficiencyGuseinovaA. R.<p>Lecturer, Department of Therapy</p>nauchnayastatya@yandex.ruAzerbaijan State Advanced Training Institute for Doctors named after A. Aliyev061120203745100511202005112020Copyright © 2020, Guseinova A.R.2020<p><strong>Objective. </strong>To study the significance of the presence and absence of carbohydrate metabolism disorders as a factor affecting the development of vitamin B<sub>12</sub> deficiency.</p>
<p><strong>Materials and methods. </strong>The data of 206 subjects, forming two main groups were analyzed: the group of carbohydrate metabolism disorders (CMDs), which included 76 women and 71 men (<em>n</em> = 147); the control group, which included 33 women and 26 men (<em>n</em> = 59). The inclusion criteria were the following: age over 35, availability of anamnestic data on pharmacotherapy, availability of data to clarify the state of carbohydrate metabolism, availability of data on vitamin B<sub>12</sub> and some other biochemical indices. Vitamin B<sub>12</sub> levels 221 pmol / l were considered normal, vitamin B<sub>12 </sub>levels from 148 pmol / l to 221 pmol/l were considered borderline (or mild deficiency), and levels of 148 pmol / l or less were considered severe vitamin B<sub>12</sub> deficiency.</p>
<p><strong>Results.</strong> The group of absent carbohydrate metabolism disorders included 59 persons and the group of carbohydrate metabolism disorders (CMDs) included T2DM patients (<em>n</em> = 123) and individuals with prediabetes (<em>n</em> = 24), i.e. the total number of the examined persons in CMD group was equal to 147. The average level of vitamin B<sub>12</sub> in the control group (<em>n</em> = 59) was 401.6 and 138.06 pmol / l, and in CMD group (<em>n</em> = 147) it was equal to 342.1 133.10 pmol/l. The differences between the groups were statistically significant (<em>p</em> 0.01), that suggested the significance of CMDs as a risk factor for vitamin B<sub>12</sub> deficiency. Vitamin B<sub>12</sub> deficiency was combined with the presence of CMDs in 32 (21.8 %) cases. In 115 cases (78.2 %), the presence of CMDs was combined with the absence of vitamin B<sub>12</sub> deficiency. In 8 cases (13.5 %), there were no CMDs, but there was vitamin B<sub>12</sub> deficiency. In 51 cases (86.4 %), no CMDs and vitamin B<sub>12</sub> deficiency was noted.</p>
<p><strong>Conclusions. </strong>Despite the presence of a statistically significant decrease in vitamin B<sub>12</sub> levels in CMD group (342.1 133.10 pmol / l vs 401.6 and 138.06 pmol/ l; <em>p</em> 0.01) and a high incidence rate of vitamin B<sub>12</sub> deficiency in CMD group (21.8 % and 13.5 %, respectively), the study results do not allow us to consider the presence of CMDs to be the risk factor for vitamin B<sub>12</sub> deficiency.</p>Vitamin B12 deficiencycarbohydrate metabolism disordersrisk factorsНедостаточность витамина В12нарушения углеводного обменафакторы риска[O’Leary F., Sammman S. Vitamin B12 in Health and Desease. Nutrients 2010; 2: 299–316.][Minot G.R., Murphy W.P. Treatment of pernicious anemia by a special diet. JAMA. 1926; 87: 470-476.][The Nobel Prize in Physiology or Medicine 1934. Nobel Media AB 2018, available at: https://www.nobelprize.org/prizes/medicine/193 4/summary/][De Jager J., Kooy A., Lehert P., Wulffele M.G. et al. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B12 deficiency: randomised placebo controlled trial. BMJ 2010; 340: 2181, available at: https://www.bmj.com/content/bmj/340/bmj.c2181.full.pdf.][Aroda V.R., Edelstein S.L., Goldberg R.B., Knowler W.C. et al. Long-term metformin use and vitamin B12 deficiency in the Diabetes Prevention Program Outcomes Study. J Clin Endocrinol Metab 2016; 101: 1754–1761.][Associacija jendokrinologov, diabetologov i terapevtov Azerbajdzhanskoj Respubliki. Diabetes diagnosis, prevention and treatment standards. Baku, 2017; 134 [in Azerbaijani].][American Diabetes Assosiation. Standards of Medical Care in Diabetes. Diabetes Care 2018; 41: S1–S159.][American Diabetes Assosiation. Standards of Medical Care in Diabetes. Diabetes Care 2019; 42: S1–S193.][Brito A., Mujica-Coopman M.F., Olivares M., De Romana D.L. et al. Folate and Vitamin B12 Status in Latin America and the Caribbean: An Update. Food and Nutrition Bulletin 2015; 36: S109–S118.][Med Calc. Easy-to-use statistical software, available at: https://www.medcalc.org/calc/comparison_of_proportions.php.][Kras'ko O. Statistical data analysis in medical research. Uchebno-metodicheskoe posobie. Minsk 2014; 126 (in Russian).]