PSUN315 Elevated Serum B12 Levels are Associated with Diabetes

Abstract

Abstract Background Vitamin B12 is an essential nutrient found in diverse food sources. Prokaryotic beings are capable of production through de novo aerobic and anaerobic biochemical reactions. It is common wisdom that diabetics, especially those receiving metformin, have vitamin B12 deficiency. However, little is known about the relationship between B12 levels and glucose tolerance. Methods A retrospective analysis of vitamin B12 levels and glucose tolerance in a representative U.S. population was performed. Records from the 2011-2014 National Health and Nutrition Examination Survey were reviewed. Individuals over the age of 20 were grouped according to a history of diabetes, Hb A1c levels, and fasting or 2-hour glucose tolerance test results into normal glucose (NG), abnormal glucose tolerance (AGT), and diabetes. A total of 19, 931 individuals were identified. Sample weighted analyses were performed with adjustment for the covariates of age, gender, body mass index, race/ethnicity, education, poverty index, current smoking, current alcohol consumption, family history of diabetes, vitamin B12 intake, and metformin use. Results Serum vitamin B12 levels were significantly higher among individuals with diabetes compared to those defined as AGT and NGT patients (496±14, 453±6, and 443±8 pmol/L, mean ± SE respectively, P=0.004). Diabetic individuals taking metformin had significantly lower serum vitamin B12 levels than diabetics not using metformin (445±16 vs. 518±13 pmol/L, P=0.0005). After exclusion of metformin users, diabetic subjects still had significantly higher serum vitamin B12 levels than NGT and AGT individuals (498±15, 456±6, and 445±8 pmol/L, respectively, P=0.006). The frequency of vitamin B12 supplement use was similar among diabetic, NGT, and AGT subjects (31%, 33%, and 31%, respectively, P=0.30). Likewise, the quantity of vitamin B12 supplementation was similar among the groups (233±34, 189±18, 192±24 mcg/day, respectively, P=0.50). Summary Retrospective analysis found higher serum B12 levels in diabetics compared to individuals with abnormal and normal glucose homeostasis. This novel finding was not secondary to exogenous B12 supplementation in diabetic individuals. Not unexpectedly, in individuals with diabetes, metformin exerted a negative effect on B12 levels. While the causes of elevated B12 in these individuals remain unknown, analysis of the intestinal bacterial flora and metabolome may be warranted. Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.