J Nutr. 2023 Jun 9:S0022-3166(23)72410-3. doi: 10.1016/j.tjnut.2023.05.031. Online ahead of print.
ABSTRACT
BACKGROUND: Vitamin B12 is involved in several physiological functions, and malabsorption is reported with medication use.
OBJECTIVE: Studies have reported an inverse association between use of metformin or acid lowering agents (ALAs) such as proton pump inhibitors (PPIs), histamine 2 receptor antagonists (H2RAs) and blood vitamin B12 concentration, due to malabsorption. The concomitant use of these medications is under reported. We sought to examine these associations in a cohort of Boston-area Puerto Rican adults.
METHODS: This analysis was conducted within the Boston Puerto Rican Health Study (BPRHS), an ongoing longitudinal cohort that enrolled 1499 Puerto Rican adults aged 45-75y at baseline. Our study comprised 1428, 1155 and 782 participants at baseline, wave2 (2.2y from baseline) and wave3 (6.2y from baseline), respectively. Covariate-adjusted linear and logistic regression were used to examine association between baseline medication use and vitamin B12 concentration or deficiency (vitamin B12 < 148 pmol/L or methylmalonic acid (MMA) > 271nmol/L), and long-term medication use (continuous use for ∼6.2y) and wave3 B12 concentration and deficiency. Sensitivity analyses were done to examine these associations in B12 supplement users.
RESULTS: At baseline, we observed an association between metformin use (β = -0.069, P = 0.03) and concomitant ALA and metformin use (β = -0.112, P = 0.02) and vitamin B12 concentration, but not deficiency. We did not observe associations between ALA, PPI, or H2RA, individually, with vitamin B12 concentration or deficiency.
CONCLUSIONS: These results suggest an inverse relationship between metformin and concomitant ALA and metformin use and serum vitamin B12 concentration.
PMID:37302714 | DOI:10.1016/j.tjnut.2023.05.031
