The role ofHelicobacter pyloriin vitamin-B12deficiency due to metformin use

Background Metformin is widely used for the treatment of type-2 diabetes (T2D) but was shown to cause vitamin-B(12)deficiency.H pyloriinfection was also suggested to cause vitamin-B(12)deficiency. This study aimed to elucidate the relationships in this triad by investigating vitamin-B(12)deficiency andH pyloriinfection in T2D patients using metformin. Materials and Methods This descriptive cross-sectional study recruited T2D patients using metformin from a primary care center and examined their socioeconomic status, accompanying complaints, medication use, and hemogram parameters such as serum vitamin B-12, calcium, and hemoglobin. The presence ofH pyloriinfection was determined through stool antigen test. Results Study included 421 T2D patients on metformin regimen: 213 (50.6%) males and 208 (49.4%) females. The mean duration of diabetes was 9.88 +/- 7.32 years, and the total metformin dose was 1925.5 +/- 236.7 mg/d. Almost half of the participants (n = 199, 47.3%) hadH pyloriinfection, and more than half (n = 222, 52.7%) had vitamin-B(12)deficiency. The rate of vitamin-B(12)deficiency was significantly higher among those withH pyloriinfection. No significant relationship was found between the daily metformin dose and vitamin-B(12)deficiency. Conclusions This study supported the role ofH pyloriinfection in vitamin-B(12)deficiency. However, the effects of increased metformin dose andH pyloriinfection on vitamin-B(12)levels were not additive. It is recommended that vitamin-B(12)levels in T2D patients are monitored and those with vitamin-B(12)deficiency, regardless of metformin dose, are screened forH pyloriand, if necessary, treated.