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:
  • ,
  • 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
Pages (from-to)157-165
Publication statusPublished - 2015

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