Hyperglycemia and Metformin Use Are Associated With B Vitamin Deficiency and Cognitive Dysfunction in Older Adults

• DOI: 10.1210/jc.2018-01791
• Publication Date: 2019-03-28T13:13:22Z
• Authors: Kirsty M Porter; Mary Ward; Catherine F Hughes; Maurice O’Kane; Leane Hoey; Adrian McCann; Anne M Molloy; Conal Cunningham; Miriam C Casey; Fergal Tracey; Sean Strain; Kevin McCarroll; Eamon Laird; Alison M Gallagher; Helene McNulty
• Keywords: B vitamins

Abstract Context Emerging evidence suggests that deficiencies of folate-related B vitamins can arise with metformin treatment and are independently linked cognitive dysfunction, a comorbidity diabetes. Objective To determine the impact hyperglycemia use on relevant vitamin biomarkers outcomes in older adults. Setting Participants Community-dwelling adults (74.1 ± 8.3 years, n = 4160) without dementia, recruited to Trinity, Ulster Department Agriculture cohort study 2008 2012, were classified as normoglycemic (n 1856) or hyperglycemic, based HbA1c ≥5.7% (39 mmol/mol), either 318) 1986) treatment. Main Outcome Measures Biomarkers folate, B12, B6, riboflavin measured. Cognitive assessments included Repeatable Battery for Assessment Neuropsychological Status (RBANS) Frontal (FAB). Results Metformin was associated higher risk deficiency B12 (combined index ≤−1; OR 1.45; 95% CI, 1.03 2.02) B6 (plasma pyridoxal 5-phosphate <30.0 nmol/L; 1.48; 1.02 2.15). Fortified foods when eaten regularly had positive all biomarkers, even hyperglycemia. After adjustment covariates, an increased dysfunction assessed RBANS (OR 1.36; 1.80) FAB 1.34; 1.74). Conclusions Use by is poorer performance; may be implicated. optimize status beneficial maintaining better health people at