Vitamin B status in patients with type 2 diabetes mellitus with and without incipient nephropathy. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Nix, Wilfred A.; Zirwes, Rudolf; Bangert, Volkhard; Kaiser, Raimund Peter; Schilling, Matthias; Hostalek, Ulrike; Obeid, Rima
• Is Part Of: Diabetes research and clinical practice. Volume 107:Issue 1(2015)
• Page Start: 157
• Page End: 165
• Publication Date: 2015-01
• Subjects: Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2014.09.058
• Languages: English
• ISSNs: 0168-8227

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Aim</title> <p id="spar0005">To investigate the vitamin B status, with particular focus on vitamin B<sub>6</sub>, in adults with and without incipient nephropathy secondary to type 2 diabetes mellitus.</p> </sec> <sec> <title id="sect0015">Methods</title> <p id="spar0010">Plasma and/or urine concentrations of vitamins B<sub>6</sub>, B<sub>1</sub>, B<sub>12</sub>, related vitamers and biomarkers (including total homocysteine, methylmalonic acid) were measured in 120 adults with type 2 diabetes (including 46 patients with microalbuminuria) and 52 non-diabetic control subjects.</p> </sec> <sec> <title id="sect0020">Results</title> <p id="spar0015">Plasma concentrations of pyridoxal 5′-phosphate (PLP) were significantly lower in patients with type 2 diabetes than in control subjects (median: 22.7 nmol/L, diabetes with microalbuminuria; 26.8 nmol/L, diabetes without microalbuminuria; 39.5 nmol/L, non-diabetic control; <italic>p</italic> < 0.0001). The prevalence of low PLP (<30 nmol/L) was 63%, 58%, and 25% in the diabetes groups with and without microalbuminuria and the control group, respectively. Plasma levels of pyridoxine and pyridoxal were also lower (<italic>p</italic> < 0.0001), but levels of pyridoxamine, pyridoxamine 5′-phosphate, and pyridoxic acid were higher in both groups with diabetes compared to the control group (<italic>p</italic> < 0.001). Thiamine deficiency was highly prevalent in all groups, whereas low vitamin B<sub>12</sub> and elevated methylmalonic acid were rare. Increased levels of C-reactive protein and soluble vascular cell adhesion molecule-1 were observed in the groups with diabetes (<italic>p</italic> < 0.05, versus healthy control).</p> </sec> <sec> <title id="sect0025">Conclusions</title> <p id="spar0020">Deficiency of vitamin B<sub>6</sub> (PLP, pyridoxine, pyridoxal) and vitamin B<sub>1</sub> (thiamine) was prevalent in type 2 diabetes. Incipient nephropathy was associated with more pronounced alterations in vitamin B<sub>6</sub> metabolism and stronger indications of endothelial dysfunction and inflammation.</p> </sec> </abstract>