{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T08:07:02Z","timestamp":1774426022328,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T00:00:00Z","timestamp":1592524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Metformin is widely used for the treatment of type\u20102 diabetes (T2D) but was shown to cause vitamin\u2010B<jats:sub>12<\/jats:sub> deficiency. <jats:italic>H\u00a0pylori<\/jats:italic> infection was also suggested to cause vitamin\u2010B<jats:sub>12<\/jats:sub> deficiency. This study aimed to elucidate the relationships in this triad by investigating vitamin\u2010B<jats:sub>12<\/jats:sub> deficiency and <jats:italic>H\u00a0pylori<\/jats:italic> infection in T2D patients using metformin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This descriptive cross\u2010sectional study recruited T2D patients using metformin from a primary care center and examined their socioeconomic status, accompanying complaints, medication use, and hemogram parameters such as serum vitamin B<jats:sub>12<\/jats:sub>, calcium, and hemoglobin. The presence of <jats:italic>H\u00a0pylori<\/jats:italic> infection was determined through stool antigen test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Study included 421 T2D patients on metformin regimen: 213 (50.6%) males and 208 (49.4%) females. The mean duration of diabetes was 9.88\u00a0\u00b1\u00a07.32\u00a0years, and the total metformin dose was 1925.5\u00a0\u00b1\u00a0236.7\u00a0mg\/d. Almost half of the participants (n\u00a0=\u00a0199, 47.3%) had <jats:italic>H\u00a0pylori<\/jats:italic> infection, and more than half (n\u00a0=\u00a0222, 52.7%) had vitamin\u2010B<jats:sub>12<\/jats:sub> deficiency. The rate of vitamin\u2010B<jats:sub>12<\/jats:sub> deficiency was significantly higher among those with <jats:italic>H\u00a0pylori<\/jats:italic> infection. No significant relationship was found between the daily metformin dose and vitamin\u2010B<jats:sub>12<\/jats:sub> deficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study supported the role of <jats:italic>H\u00a0pylori<\/jats:italic> infection in vitamin\u2010B<jats:sub>12<\/jats:sub> deficiency. However, the effects of increased metformin dose and <jats:italic>H\u00a0pylori<\/jats:italic> infection on vitamin\u2010B<jats:sub>12<\/jats:sub> levels were not additive. It is recommended that vitamin\u2010B<jats:sub>12<\/jats:sub> levels in T2D patients are monitored and those with vitamin\u2010B<jats:sub>12<\/jats:sub> deficiency, regardless of metformin dose, are screened for <jats:italic>H\u00a0pylori<\/jats:italic> and, if necessary, treated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12718","type":"journal-article","created":{"date-parts":[[2020,6,19]],"date-time":"2020-06-19T23:24:48Z","timestamp":1592609088000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The role of <i>Helicobacter pylori<\/i> in vitamin\u2010B<sub>12<\/sub> deficiency due to metformin use"],"prefix":"10.1111","volume":"25","author":[{"given":"Melih Tansel","family":"G\u00f6k\u0131\u015f\u0131k","sequence":"first","affiliation":[{"name":"Department of Family Medicine Antalya Training and Research Hospital Health Sciences University  Antalya 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