Endocrine Abstracts

Introduction: Diabetic nephropathy (DN) is a major complication of diabetes and may be fatal at an end stage kidney disease. Several mechanisms lead to the basic lesion of DN (thickening of the glomerular basement membrane) including oxidative stress, inflammation and hyperhomocysteinemia. Being coenzymes of homocysteine metabolism, a deficiency in vitamin B12 and B9 will cause an accumulation of circulating homocysteine. Our objective was to evaluate the association between the deficiency of these vitamins and DN in type 2 diabetics.

Methods: It was a cross-sectional study that included 100 type 2 diabetic patients. Vitamin B12 deficiency was defined by a level < 203 pg/ml. Vitamin B9 deficiency was certain for a level < 3 ng/ml and possible for a level between 3 and 6 ng/ml. DN was considered in the presence of albuminuria > 30 mg/24 h or a Glomerular Filtration Rate <60 ml/min

Results: In our population, 40% of patients had positive albuminuria and 11% had renal failure of all stages. In total, 43% of patients had DN. It was significantly associated to diabetic retinopathy (P=0.015) and diabetic neuropathy (P=0.039). The average vitamin B12 level was 220.62 pg/ml for patients with DN vs 209.43 pg/ml for those without DN. Vitamin B12 deficiency was not significantly associated to DN (P=0.420). The average vitamin B9 level was 8.83 ng/ml for patients with DN and slightly higher at 9.05 ng/ml for those without DN but with no significant association between possible vitamin B9 deficiency and DN (P=0.796).

Conclusion: Our study didn’t show an association between vitamin B12 and B9 deficiency and DN. However, given the multitude of studies on the subject, more in-depth studies would be necessary to confirm the absence of this association.