二甲双胍所致血清维生素B_(12)水平降低的研究现状

Research progress on serum vitamin B_(12) reduction induced by metformin

二甲双胍是被广泛应用于2型糖尿病临床治疗的药物,较多的临床报道提示长期使用二甲双胍可导致机体循环中维生素B_(12)水平降低甚至出现维生素B_(12)缺乏。维生素B_(12)缺乏可引发糖尿病患者出现周围神经病变、巨幼细胞性贫血以及加重其原有的心血管疾病,且维生素B_(12)缺乏导致的神经病变易被误诊为糖尿病神经病变。不同研究中二甲双胍引起的维生素B_(12)水平降低的发生率差异较大,其背后的机制尚未被完全阐明。该文就二甲双胍所致维生素B_(12)水平降低的研究现状进行综述,分析相关研究结果差异较大的原因,以期对正确识别并防治二甲双胍所致的维生素B_(12)水平降低提供参考。

Metformin is a drug which has been widely used in clinical practice.Multiple clinical trials have suggested that long-term use of metformin could result in serum vitamin B_(12) reduction even deficiency,while vitamin B_(12) deficiency might lead to peripheral neuropathy,megaloblastic anemia and aggravation of preexisting cardiovascular diseases in diabetic patients.Vitamin B_(12) deficiency-induced neuropathy is easily misdiagnosed as diabetic neuropathy.However,the incidence of vitamin B_(12) reduction induced by metformin intervention varies among different studies,and the underlying mechanisms are not fully elucidated.In this paper,research progress on vitamin B_(12) reduction caused by metformin was reviewed and the possible reasons of differences in the incidence rate were analyzed,aiming to identify,prevent and treat vitamin B_(12) reduction caused by metformin.