The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus

被引:41
作者
Hashem, Manal Mohammed [1 ]
Esmael, Ahmed [2 ]
Nassar, Abdelfattah Kasem [3 ]
El-Sherif, Mohammed [2 ]
机构
[1] Zagazig Univ, Internal Med Dept, Fac Med, Zagazig, Egypt
[2] Mansoura Univ, Mansoura Fac Med, Neurol Dept, Mansoura 35516, Dakahlia, Egypt
[3] Al Azhar Univ, Phys Med & Rehabil Fac Med, Rheumatol Dept, Cairo, Egypt
关键词
VITAMIN-B12; DEFICIENCY; HOMOCYSTEINE; ASSOCIATION; POLYNEUROPATHY;
D O I
10.1038/s41598-021-81631-8
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Metformin-treated diabetics (MTD) showed a decrease in cobalamin, a rise in homocysteine, and methylmalonic acid, leading to accentuated diabetic peripheral neuropathy (DPN). This study aimed to determine whether or not metformin is a risk factor for DPN. We compared MTD to non-metformin-treated diabetics (NMTD) clinically using the Toronto Clinical Scoring System (TCSS), laboratory (methylmalonic acid, cobalamin, and homocysteine), and electrophysiological studies. Median homocysteine and methylmalonic acid levels in MTD vs. NMTD were 15.3 vs. 9.6 mu mol/l; P<0.001 and 0.25 vs. 0.13 <mu>mol/l; P=0.02, respectively with high statistical significance in MTD. There was a significantly lower plasma level of cobalamin in MTD than NMTD. Spearman's correlation showed a significant negative correlation between cobalamin and increased dose of metformin and a significant positive correlation between TCSS and increased dose of metformin. Logistic regression analysis showed that MTD had significantly longer metformin use duration, higher metformin dose>2 g, higher TCSS, lower plasma cobalamin, and significant higher homocysteine. Diabetics treated with metformin for prolonged duration and higher doses were associated with lower cobalamin and more severe DPN.
引用
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页数:9
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