Vitamin B status in patients with type 2 diabetes mellitus with and without incipient nephropathy

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  • Wilfred A Nix, Akademie für Ärztliche Fortbildung in Rheinland-Pfalz, Mainz, Germany. Electronic address: nix@arztkolleg.de.
  • ,
  • Rudolf Zirwes, Private Practice, Daun, Germany., Unknown
  • Volkhard Bangert, Private Practice, Daun, Germany., Unknown
  • Raimund Peter Kaiser, Private Practice, Kelberg, Germany., Unknown
  • Matthias Schilling, Private Practice, Wittlich, Germany., Unknown
  • Ulrike Hostalek, Merck KGaA, Darmstadt, Germany., Unknown
  • Rima Obeid, Denmark

AIM: To investigate the vitamin B status, with particular focus on vitamin B6, in adults with and without incipient nephropathy secondary to type 2 diabetes mellitus.

METHODS: Plasma and/or urine concentrations of vitamins B6, B1, B12, 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.

RESULTS: Plasma concentrations of pyridoxal 5'-phosphate (PLP) were significantly lower in patients with type 2 diabetes than in control subjects (median: 22.7nmol/L, diabetes with microalbuminuria; 26.8nmol/L, diabetes without microalbuminuria; 39.5nmol/L, non-diabetic control; p<0.0001). The prevalence of low PLP (<30nmol/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 (p<0.0001), but levels of pyridoxamine, pyridoxamine 5'-phosphate, and pyridoxic acid were higher in both groups with diabetes compared to the control group (p<0.001). Thiamine deficiency was highly prevalent in all groups, whereas low vitamin B12 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 (p<0.05, versus healthy control).

CONCLUSIONS: Deficiency of vitamin B6 (PLP, pyridoxine, pyridoxal) and vitamin B1 (thiamine) was prevalent in type 2 diabetes. Incipient nephropathy was associated with more pronounced alterations in vitamin B6 metabolism and stronger indications of endothelial dysfunction and inflammation.

Original languageEnglish
JournalDiabetes Research and Clinical Practice
Volume107
Issue1
Pages (from-to)157-165
ISSN0168-8227
DOIs
Publication statusPublished - 2015

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