{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T10:44:07Z","timestamp":1782297847430,"version":"3.54.5"},"reference-count":22,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","nmcd-journal.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Nutrition, Metabolism and Cardiovascular Diseases"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.numecd.2025.104193","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T15:51:38Z","timestamp":1749657098000},"page":"104193","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":3,"title":["Metformin is associated with low levels of vitamin B12 with no effect on other vitamin levels. A selective action of metformin"],"prefix":"10.1016","volume":"35","author":[{"given":"Nicol\u00f2","family":"Vigolo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Toffalini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Rolli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Paviati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Gelati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maddalena","family":"Trombetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Danese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1085-554X","authenticated-orcid":false,"given":"Giacomo","family":"Zoppini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"Supplement_1","key":"10.1016\/j.numecd.2025.104193_bib1","doi-asserted-by":"crossref","first-page":"S158","DOI":"10.2337\/dc24-S009","article-title":"Pharmacologic approaches to glycemic treatment: standards of Care in diabetes","volume":"47","year":"2024","journal-title":"Diabetes Care"},{"key":"10.1016\/j.numecd.2025.104193_bib2","doi-asserted-by":"crossref","first-page":"17040","DOI":"10.1038\/nrdp.2017.40","article-title":"Vitamin B12 deficiency","volume":"3","author":"Green","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"10.1016\/j.numecd.2025.104193_bib3","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.3390\/jcm13082176","article-title":"The vitamin B consensus panelists Group.Diagnosis, treatment and long-term management of vitamin B12 deficiency in adults: a delphi expert consensus","volume":"13","author":"Obeid","year":"2024","journal-title":"J Clin Med"},{"key":"10.1016\/j.numecd.2025.104193_bib4","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1007\/s11033-022-07954-5","article-title":"Role of metformin in inflammation","volume":"50","author":"Feng","year":"2023","journal-title":"Mol Biol Rep"},{"key":"10.1016\/j.numecd.2025.104193_bib5","doi-asserted-by":"crossref","first-page":"916","DOI":"10.4239\/wjd.v12.i7.916","article-title":"Long-term metformin therapy and vitamin B12 deficiency: an association to bear in mind","volume":"12","author":"Infante","year":"2021","journal-title":"World J Diabetes"},{"key":"10.1016\/j.numecd.2025.104193_bib6","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1681\/ASN.0000000000000227","article-title":"CKD-EPI and EKFC GFR estimating equations: performance and other considerations for selecting equations for implementation in adults","volume":"34","author":"Inker","year":"2023","journal-title":"J Am Soc Nephrol"},{"key":"10.1016\/j.numecd.2025.104193_bib7","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000017918","article-title":"Association between metformin dose and vitamin B12 deficiency in patients with type 2 diabetes","volume":"98","author":"Kim","year":"2019","journal-title":"Medicine (Baltim)"},{"key":"10.1016\/j.numecd.2025.104193_bib8","first-page":"780","article-title":"Effect of metformin on plasma homocysteine, vitamin B12 and folic acid: a cross-sectional study in patients with type 2 diabetes mellitus","volume":"87","author":"Pongchaidecha","year":"2004","journal-title":"J Med Assoc Thai"},{"key":"10.1016\/j.numecd.2025.104193_bib9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0302500","article-title":"Vitamin B12 deficiency in diabetic patients treated with metformin: a cross-sectional study","volume":"19","author":"Huynh","year":"2024","journal-title":"PLoS One"},{"key":"10.1016\/j.numecd.2025.104193_bib10","first-page":"340","article-title":"Long-term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomized placebo-controlled trial","volume":"20","author":"De Jager","year":"2010","journal-title":"BMJ"},{"key":"10.1016\/j.numecd.2025.104193_bib11","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1210\/jc.2015-3754","article-title":"Long-term metformin use and vitamin B12 deficiency in the diabetes prevention program outcomes study","volume":"101","author":"Aroda","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.numecd.2025.104193_bib12","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.diabet.2016.03.008","article-title":"Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: a systematic review and meta-analysis","volume":"42","author":"Chapman","year":"2016","journal-title":"Diabetes Metab"},{"key":"10.1016\/j.numecd.2025.104193_bib13","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1111\/1753-0407.13428","article-title":"The effects of daily dose and treatment duration of metformin on the prevalence of vitamin B12 deficiency and peripheral neuropathy in Chinese patients with type 2 diabetes mellitus: a multicenter cross-sectional study","volume":"15","author":"Gao","year":"2023","journal-title":"J Diabetes"},{"key":"10.1016\/j.numecd.2025.104193_bib14","doi-asserted-by":"crossref","first-page":"4965","DOI":"10.9734\/BJMMR\/2014\/12040","article-title":"Could mean platelet volume and red cell distribution width predict vitamin B12 deficiency?","volume":"4","author":"Aktas","year":"2014","journal-title":"Br J Med Med Res"},{"key":"10.1016\/j.numecd.2025.104193_bib15","article-title":"Long-term use of metformin and vitamin B12 deficiency in diabetes","author":"Hussain","year":"2024","journal-title":"Curr Drug Saf"},{"key":"10.1016\/j.numecd.2025.104193_bib16","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.2337\/diacare.23.9.1227","article-title":"Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin","volume":"23","author":"Bauman","year":"2000","journal-title":"Diabetes Care"},{"key":"10.1016\/j.numecd.2025.104193_bib17","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.biochi.2015.11.006","article-title":"Absorption and blood\/cellular transport of folate and cobalamin: pharmacokinetic and physiological considerations","volume":"126","author":"Alpers","year":"2016","journal-title":"Biochimie"},{"key":"10.1016\/j.numecd.2025.104193_bib18","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/BF01219698","article-title":"Alteration of bile acid metabolism and vitamin-B12-absorption in diabetics on biguanides","volume":"13","author":"Caspary","year":"1977","journal-title":"Diabetologia"},{"issue":"15","key":"10.1016\/j.numecd.2025.104193_bib19","article-title":"Advances in the mechanism of metformin with wide-ranging effects on regulation of the intestinal microbiota","volume":"24","author":"Wang","year":"2024","journal-title":"Front Microbiol"},{"key":"10.1016\/j.numecd.2025.104193_bib20","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1172\/JCI68815","article-title":"Metformin interferes with bile acid homeostasis through AMPK-FXR crosstalk","volume":"124","author":"Lien","year":"2014","journal-title":"J Clin Investig"},{"key":"10.1016\/j.numecd.2025.104193_bib21","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1016\/j.biochi.2013.02.002","article-title":"Metformin increases liver accumulation of vitamin B12 - an experimental study in rats","volume":"95","author":"Greibe","year":"2013","journal-title":"Biochimie"},{"key":"10.1016\/j.numecd.2025.104193_bib22","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1007\/BF00275941","article-title":"Malabsorption of vitamin B12 and intrinsic factor secretion during biguanide therapy","volume":"24","author":"Adams","year":"1983","journal-title":"Diabetologia"}],"container-title":["Nutrition, Metabolism and Cardiovascular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0939475325003473?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0939475325003473?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T22:15:48Z","timestamp":1760220948000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0939475325003473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["S0939475325003473"],"URL":"https:\/\/doi.org\/10.1016\/j.numecd.2025.104193","relation":{},"ISSN":["0939-4753"],"issn-type":[{"value":"0939-4753","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Metformin is associated with low levels of vitamin B12 with no effect on other vitamin levels. A selective action of metformin","name":"articletitle","label":"Article Title"},{"value":"Nutrition, Metabolism and Cardiovascular Diseases","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.numecd.2025.104193","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Italian Diabetes Society, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}],"article-number":"104193"}}