Comparison of serum folic acid and Vitamin B12 among type 2 diabetes mellitus patients with and without nephropathy; a cross sectional observational study from eastern India

Soumyajyoti Kundu, A. Dubey, Sisir Chakraborty, P. K. Sinha, Animesh Maiti, Swati Banerjee, P. Banerjee
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Abstract

Abstract Background & aims: Diabetic nephropathy is the leading cause of chronic kidney disease and end –stage renal disease. According to earlier studies serum folic acid and vitamin B12 were found to be reduced in such patients. Therefore, the present study was conducted to estimate and compare the serum folic acid and vitamin B12 values of diabetic mellitus patients with and without nephropathy. Materials and methods: A single institution based cross sectional study was conducted in Kolkata from March 2018 to September 2019.203 adult with at least five years history of type 2 diabetes mellitus were subdivided into two groups’ nephropathy and non-nephropathy. The cut off value for inclusion into nephropathy group was urinary albumin-creatinine ratio of more than equal to 30gm/dl. Serum folic acid and vitamin B12 values of both groups were estimated by Chemiluminescence assay and later statistically compared for result. Result: Overall 127 patients were grouped in non-nephropathy while rest 76 belonged to nephropathy. Both folic acid (4.68±3.64 versus 7.02±3.89; p<0.0001) and Vitamin B 12 (219.54±56.53 versus 343.98±32.1; p<0.0001) values were found to significantly lower in the nephropathy group. Non-nephropathy patients also displayed better glycemic profile in terms of HbA1c.Conclusion: Patients with diabetic nephropathy displayed lower levels of serum folic acid as well as vitamin B12 in comparison to the patients who did not develop nephropathy. Besides renal parameters the glycemic statuses of nephropathy patients were also poor. Keywords: Diabetic nephropathy, folic acid, Vitamin B12, urinary albumin –creatinine raio, Chemiluminescence assay.
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2型糖尿病伴与不伴肾病患者血清叶酸和维生素B12的比较来自印度东部的横断面观察研究
摘要背景与目的:糖尿病肾病是慢性肾脏疾病和终末期肾脏疾病的主要病因。根据早期的研究,发现这些患者血清中叶酸和维生素B12含量降低。因此,本研究对合并肾病和不合并肾病的糖尿病患者的血清叶酸和维生素B12值进行估算和比较。材料与方法:2018年3月至2019年9月,在加尔各答开展了一项基于单一机构的横断面研究,将203名至少有5年2型糖尿病病史的成年人分为肾病组和非肾病组。尿白蛋白-肌酐比值大于等于30gm/dl为纳入肾病组的临界值。采用化学发光法测定两组患者血清叶酸和维生素B12值,并对结果进行统计学比较。结果:非肾病组127例,肾病组76例。叶酸(4.68±3.64 vs 7.02±3.89);p<0.0001)和维生素B 12(219.54±56.53 vs 343.98±32.1;P <0.0001)值在肾病组显著降低。非肾病患者在HbA1c方面也表现出更好的血糖谱。结论:与未发生肾病的患者相比,糖尿病肾病患者的血清叶酸和维生素B12水平较低。除了肾脏参数外,肾病患者的血糖状况也很差。关键词:糖尿病肾病,叶酸,维生素B12,尿白蛋白-肌酐比,化学发光法。
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