Prevalence of vitamin B12 deficiency in South Indians with different grades of glucose tolerance
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To determine the prevalence of vitamin B12 deficiency in an urban south Indian population in individuals with different grades of glucose tolerance.
A total of 1500 individuals [900 normal glucose tolerance (NGT), 300 prediabetes and 300 type 2 diabetes (T2DM)] who were not on vitamin B12 supplementation were randomly selected from the Chennai Urban Rural Epidemiological Study (CURES) follow-up study. Anthropometric, clinical and biochemical investigations, which included vitamin B12, insulin, homocysteine, HbA1c and serum lipids, were measured. Vitamin B12 ≤ 191 pg/ml was defined as absolute vitamin B12 deficiency and vitamin B12 > 191 pg/ml and ≤ 350 pg/ml as borderline deficiency.
The mean levels of vitamin B12 significantly decreased with increasing degrees of glucose tolerance (NGT 444 ± 368; prediabetes 409 ± 246; T2DM 389 ± 211 pg/ml, p = 0.021). The prevalence of absolute vitamin B12 deficiency was 14.9% while 37.6% had borderline deficiency. The prevalence of absolute vitamin B12 deficiency was significantly higher among individuals with T2DM (18.7%) followed by prediabetes (15%) and NGT(13.7%) [p for trend = 0.05]. The prevalence of vitamin B12 significantly increased with age (p < 0.05) and in those with abdominal obesity (p < 0.001). Men and vegetarians had twice the risk of vitamin B12 deficiency compared to women and non-vegetarians, respectively. Among individuals with NGT, prediabetes and T2DM, vitamin B12 negatively correlated with homocysteine.
This study reports that the levels of vitamin B12 decreased with increasing severity of glucose tolerance.
KeywordsVitamin B12 Diabetes Glucose tolerance Prevalence South Indians
The authors acknowledge the Research Society for the Study of Diabetes in India (RSSDI) for the financial support for the study through their research grant (Project No: RSSDI/HQ/Grants/2014/250). We also thank the participants for their cooperation.
Compliance with ethical standards
Conflict of interest
All authors have no relevant conflict of interest to disclose.
Ethical standard statement
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all patients for being included in the study which has done according to the ethical standards and in keeping with Helsinki Declaration of 2008 (ICH GCP).
- 1.Miller A, Korem M, Almog R, Galboiz Y (2005) Vitamin B12, demyelination, remyelination and repair in multiple sclerosis. J NeurolSci 233:93–97Google Scholar
- 4.Klee GG, (2000)Cobalamin and folate evaluation; measurement of methylmalonic acid and homocysteinevs vitamin B12 and folate. Clin Chem 46:1277–1283Google Scholar
- 10.Adaikalakoteswari A, Jayashri R, Sukumar N et al (2014) Vitamin B12 deficiency is associated with adverse lipid profile in Europeans and Indians with type 2 diabetes. Cardiovasc Diabetol. 13:129Google Scholar
- 18.Rothman KJ (1986) Modern epidemiology. Little, Brown and Company, BostonGoogle Scholar
- 20.Harrison GG, Buskirk ER, Lindsay Carter ER et al. Skinfold thickness and measurement technique. In: Lohman TG, Roche AF, Martorell R (eds) Anthropometric standardization reference manual. Human Kinetics Books, Champaign, 55–70Google Scholar
- 25.Carmel R, Green R, Rosenblatt DS, Watkins D (2003) Update on cobalamin, folate, and homocysteine. Hematol Am Soc Hematol Educ Program 2003:62–81Google Scholar
- 26.Stabler SP, Allen RH (2004) Megaloblasticanemias. In: Cecil RL, Goldman L, Ausiello DA (eds) Cecil textbook of medicine. 22nd ed, Pa Saunders, Philadelphia, 1050–1057Google Scholar
- 28.World Health Organization (2000) Redefining obesity and its treatment. Regional office for the western pacific of the. In: World health organization, international association for the study of obesity and international obesity task force. Health Communications Australia Pty Limited, St Leonards, 22–29 pGoogle Scholar
- 29.Chobanian AV, Bakris GL, Black HR et al (2003) National heart, lung, and blood institute joint national committee on prevention, detection, evaluation, and treatment of high blood pressure; national high blood pressure education program coordinating committee. The seventh report of the joint national committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-7). JAMA 289:2560–2572CrossRefGoogle Scholar
- 30.Early Treatment of Diabetic Retinopathy Study Research Group: Grading diabetic retinopathy from stereoscopic colour fundus photographs—an extension of the modified Airlie House classification (1991). ETDRS report number 10. Ophthalmology 98:786–806Google Scholar
- 33.Rose GA, Blackburn H, GillumRF et al (1982) Cardiovascular survey methods. In: Minnesota code for resting electrocardiograms, 2nd Ed, Minnesota Code, p 124–143Google Scholar
- 34.Rooke TW, Hirsch AT, Misra S et al.(2011). Society for cardiovascular angiography and interventions; society of interventional radiology; society for vascular medicine; society for vascular surgery. 2011 ACCF/AHA focused update of the guideline for the management of patients with peripheral artery disease (updating the 2005 guideline): a report of the American college of cardiology foundation/ American heart association task force on practice guidelines. J Am Coll Cardiol 58: 2020–2045CrossRefGoogle Scholar
- 53.Allen LH (2008) Causes of vitamin B12 and folate deficiency. Food Nutr Bull. 29(2_suppl1): S20-S34Google Scholar
- 54.Global Poultry Trends (2012) Chicken consumption steady in oceania, rising in Africa 2012. http://www.thepoultrysite.com/articles/2640/global-poultry-trends-2012-chicken-consumption-steady-in-oceania-rising-in-africa/. Accessed 3 Sept 2018
- 60.Baltaci D, Kutlucan A, Turker Y et al. (2013) Association of vitamin B12 with obesity, overweight, insulin resistance and metabolic syndrome, and body fat composition; primary care-based study. Med Glas (Zenica) 10:203–210Google Scholar
- 61.Kimmons JE, Blanck HM, Tohill BC, Zhang J, Khan LK (2006) Associations between body mass index and the prevalence of low micronutrient levels among US adults. Med Gen Med. 8:59Google Scholar
- 65.Tavares Bello C, Capitão RM, Sequeira Duarte J, Azinheira J, Vasconcelos C(2017) Vitamin B12 deficiency in type 2 diabetes mellitus. Acta Med Port. 30719–726Google Scholar