Haydarpasa Numune Med J. 2019; 59(1): 84-87 | DOI: 10.14744/hnhj.2018.19970

Relationship Between Insulin Resistance and Vitamin B12 Deficiency in Obese Children

Fatma Dursun¹, Nelgin Gerenli^2
1Department of Paediatric Endocrinology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey
²Department of Paediatric Gastroenterology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey

INTRODUCTION: The increase in the incidence of obesity leads to an increase in the frequency of obesity-related complications such as insulin resistance (IR), hypertension, and hyperlipidemia. This study aimed to examine the relationship between B12 levels and IR in obese patients.
METHODS: A total of 110 children aged 10–16 years who presented to pediatric endocrinology outpatient clinic for obesity were enrolled. The homeostasis model of assessment-insulin resistance (HOMA-IR) made the diagnosis of IR. The patients who had previously received B12 and metformin treatment were excluded from the study. The vitamin B12 levels between patients with and without IR were compared. The correlation between B12 levels and IR was evaluated.
RESULTS: When patients with IR were compared with those without IR, a statistically significant difference was observed in serum B12 levels (p=0.019). A strong negative correlation was observed between vitamin B12 levels and IR (r=−0.259, p=0.008).
DISCUSSION AND CONCLUSION: We found that vitamin B12 levels were significantly lower in obese children with IR. Metformin used for IR is known to have lowered the absorption of vitamin B12. In addition to screening of IR and other co-morbidities in obesity, the lack of vitamin B12 should also be investigated. If deficient, vitamin B12 should be replaced before starting metformin treatment. Further studies are needed to examine the effect of vitamin B12 deficiency on the pathogenesis of IR.

Keywords: Insulin resistance, obesity; vitamin B12 deficiency.

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Obez çocuklarda, insülin direnci ve serum vitamin B12 düzeyi arasýnda iliþki var mý?

Fatma Dursun¹, Nelgin Gerenli^2
1SBÜ. Ümraniye Eðitim ve Araþtýrma Hastanesi Çocuk Endokrinoloji, Ýstanbul, Türkiye
²SBÜ. Ümraniye Eðitim ve Araþtýrma Hastanesi Çocuk Gastroenteroloji, Ýstanbul, Turkey

GÝRÝÞ ve AMAÇ: Çocuklarda artan obezite sýklýðý, insulin direnci, hipertansiyon, hiperlipidemi gibi eþlik eden hastalýklarda da önemli bir artýþa neden olmaktadýr. Bu çalýþma obez çocuklarda vitamin B12 düzeyleri ile insulin direnci arasýndaki iliþkiyi açýklamak üzere tasarlanmýþtýr.
YÖNTEM ve GEREÇLER: Obezite tanýsýyla çocuk endokrinoloji polikliniðine baþvuran, 10-16 yaþ arasýndaki 110 hasta çalýþmaya alýndý. Ýnsulin direnci (ÝD) tanýsý homeostasis model of assessment-insulin resistance (HOMA-IR) ile belirlendi. Daha önceden vitamin B12 ve metformin tedavisi almýþ olan hastalar çalýþma dýþýnda býrakýldý. Hastalarýn B12 düzeyleri insulin direnci olan ve olmayan obez hastalar arasýnda karþýlaþtýrýldý. B12 düzeyleri ile insulin direnci arasýndaki iliþki deðerlendirildi.
BULGULAR: ÝD olan hastalarda, olmayanlara göre serum vitamin B12 düzeyleri anlamlý daha düþük saptandý (p=0,019). Vitamin B12 düzeyleri ile HOMA-IR arasýnda negatif kuvvetli bir iliþki saptandý (r=-0,259, p=0,008).
TARTIÞMA ve SONUÇ: ÝD olan obez çocuklarda, vitamin B12 düzeylerinin anlamlý olarak daha düþük olduðunu gösterdik. ÝD nedeniyle kullanýlan metforminin de vitamin B12 emilimini bozarak düþüklük yaptýðý bilinmektedir. Obezlerde ÝD ve diðer eþlik eden hastalýklar yanýnda vitamin B12 eksikliðinin de mutlaka araþtýrýlmasý gerekmektedir. Eksiklik saptanýrsa metformin tedavisi baþlamadan önce mutlaka vitamin B12 tedavisi uygulanmalýdýr. Vitamin B12 eksikliðinin ÝD patogenezindeki etkisi ile ilgili daha ileri çalýþmalara ihtiyaç vardýr.

Anahtar Kelimeler: Obezite, insulin direnci, vitamin B12 eksikliði

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