{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:16:09Z","timestamp":1790694969267,"version":"4.1.0"},"reference-count":60,"publisher":"The Endocrine Society","issue":"10","funder":[{"DOI":"10.13039\/100013206","name":"Food Institutional Research Measure","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013206","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008303","name":"Department for Employment and Learning, Northern Ireland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008303","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008303","name":"Department for Employment and Learning, Northern Ireland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008303","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Emerging evidence suggests that deficiencies of folate-related B vitamins can arise with metformin treatment and are independently linked with cognitive dysfunction, a comorbidity of diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the impact of hyperglycemia and metformin use on relevant B vitamin biomarkers and cognitive outcomes in older adults.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and Participants<\/jats:title><jats:p>Community-dwelling older adults (74.1 \u00b1 8.3 years, n = 4160) without dementia, recruited to the Trinity, Ulster and Department of Agriculture cohort study in 2008 to 2012, were classified as normoglycemic (n = 1856) or hyperglycemic, based on HbA1c \u22655.7% (39 mmol\/mol), either with (n = 318) or without (n = 1986) metformin treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Biomarkers of folate, vitamin B12, vitamin B6, and riboflavin were measured. Cognitive assessments included the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and the Frontal Assessment Battery (FAB).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Metformin use was associated with higher risk of deficiency of vitamin B12 (combined B12 index \u2264\u22121; OR 1.45; 95% CI, 1.03 to 2.02) and vitamin B6 (plasma pyridoxal 5-phosphate &lt;30.0 nmol\/L; OR 1.48; 95% CI, 1.02 to 2.15). Fortified foods when eaten regularly had a positive impact on all relevant B vitamin biomarkers, even with hyperglycemia. After adjustment for relevant covariates, metformin use was associated with an increased risk of cognitive dysfunction as assessed with the RBANS (OR 1.36; 95% CI, 1.03 to 1.80) and FAB (OR 1.34; 95% CI, 1.03 to 1.74).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Use of metformin by older adults is associated with poorer cognitive performance; B vitamin deficiency may be implicated. Fortified foods can optimize B vitamin status and may be beneficial for maintaining better cognitive health in older people with or at risk for diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1210\/jc.2018-01791","type":"journal-article","created":{"date-parts":[[2019,3,28]],"date-time":"2019-03-28T13:13:22Z","timestamp":1553778802000},"page":"4837-4847","source":"Crossref","is-referenced-by-count":66,"title":["Hyperglycemia and Metformin Use Are Associated With B Vitamin Deficiency and Cognitive Dysfunction in Older Adults"],"prefix":"10.1210","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4059-1058","authenticated-orcid":false,"given":"Kirsty M","family":"Porter","sequence":"first","affiliation":[{"name":"Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6470-1728","authenticated-orcid":false,"given":"Mary","family":"Ward","sequence":"additional","affiliation":[{"name":"Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8825-6654","authenticated-orcid":false,"given":"Catherine F","family":"Hughes","sequence":"additional","affiliation":[{"name":"Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"O\u2019Kane","sequence":"additional","affiliation":[{"name":"Clinical Chemistry Laboratory, Western Health and Social Care Trust, Altnagelvin Hospital, Londonderry, Northern Ireland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3349-2155","authenticated-orcid":false,"given":"Leane","family":"Hoey","sequence":"additional","affiliation":[{"name":"Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"McCann","sequence":"additional","affiliation":[{"name":"Bevital AS, Laboratoriebygget, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1688-9049","authenticated-orcid":false,"given":"Anne M","family":"Molloy","sequence":"additional","affiliation":[{"name":"School of Medicine, Trinity College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conal","family":"Cunningham","sequence":"additional","affiliation":[{"name":"Mercers Institute for Research on Aging, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam C","family":"Casey","sequence":"additional","affiliation":[{"name":"Mercers Institute for Research on Aging, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fergal","family":"Tracey","sequence":"additional","affiliation":[{"name":"Causeway Hospital, Northern Health and Social Care Trust, Coleraine, Northern Ireland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1633-2873","authenticated-orcid":false,"given":"Sean","family":"Strain","sequence":"additional","affiliation":[{"name":"Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"McCarroll","sequence":"additional","affiliation":[{"name":"Mercers Institute for Research on Aging, St James\u2019s Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4225-5223","authenticated-orcid":false,"given":"Eamon","family":"Laird","sequence":"additional","affiliation":[{"name":"School of Medicine, Trinity College Dublin, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2109-3472","authenticated-orcid":false,"given":"Alison M","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4366-6457","authenticated-orcid":false,"given":"Helene","family":"McNulty","sequence":"additional","affiliation":[{"name":"Nutrition Innovation Centre for Food and Health, Biomedical Sciences Research Institute, Ulster University, Coleraine, Northern Ireland, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2019,3,28]]},"reference":[{"key":"2019091011545922700_bib1","unstructured":"World Health Organisation (WHO). Global report on diabetes. 2016. Available at: www.who.int\/diabetes\/global-report\/en\/. Accessed 2 December 2018."},{"issue":"10","key":"2019091011545922700_bib2","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1001\/jama.2015.10029","article-title":"Prevalence of and trends in diabetes among adults in the United States, 1988\u20132012","volume":"314","author":"Menke","year":"2015","journal-title":"JAMA"},{"issue":"12","key":"2019091011545922700_bib3","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.2337\/dc09-0459","article-title":"Projecting the future diabetes population size and related costs for the U.S","volume":"32","author":"Huang","year":"2009","journal-title":"Diabetes Care"},{"issue":"8","key":"2019091011545922700_bib4","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.2337\/diabetes.54.8.2404","article-title":"Role of insulin secretion and sensitivity in the evolution of type 2 diabetes in the diabetes prevention program: effects of lifestyle intervention and metformin","volume":"54","author":"Kitabchi","year":"2005","journal-title":"Diabetes"},{"issue":"5763","key":"2019091011545922700_bib5","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1136\/bmj.2.5763.685","article-title":"Vitamin-B12 status of patients on long-term metformin therapy","volume":"2","author":"Tomkin","year":"1971","journal-title":"BMJ"},{"issue":"5","key":"2019091011545922700_bib6","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1111\/jgs.14761","article-title":"Long-term metformin therapy and monitoring for vitamin B12 deficiency among older veterans","volume":"65","author":"Kancherla","year":"2017","journal-title":"J Am Geriatr Soc"},{"issue":"8","key":"2019091011545922700_bib7","doi-asserted-by":"crossref","first-page":"e0160802","DOI":"10.1371\/journal.pone.0160802","article-title":"Multivitamin use and serum vitamin B12 concentrations in older-adult metformin users in REGARDS, 2003\u20132007","volume":"11","author":"Kancherla","year":"2016","journal-title":"PLoS One"},{"issue":"4","key":"2019091011545922700_bib8","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"},{"issue":"6","key":"2019091011545922700_bib9","doi-asserted-by":"crossref","first-page":"e100379","DOI":"10.1371\/journal.pone.0100379","article-title":"Vitamin B12 status in metformin treated patients: systematic review","volume":"9","author":"Liu","year":"2014","journal-title":"PLoS One"},{"issue":"1","key":"2019091011545922700_bib10","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s11739-014-1157-5","article-title":"The role of metformin on vitamin B12 deficiency: a meta-analysis review","volume":"10","author":"Niafar","year":"2015","journal-title":"Intern Emerg Med"},{"issue":"5","key":"2019091011545922700_bib11","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"},{"issue":"Pt 4","key":"2019091011545922700_bib12","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1177\/0004563212473279","article-title":"Vitamin B12 and ageing: current issues and interaction with folate","volume":"50","author":"Hughes","year":"2013","journal-title":"Ann Clin Biochem"},{"key":"2019091011545922700_bib13","first-page":"27","article-title":"Biomarkers and algorithms for the diagnosis of vitamin B12 deficiency [published correction appears in Front Mol Biosci. 2017;4:53.]","volume":"3","author":"Hannibal","year":"2016","journal-title":"Front Mol Biosci"},{"issue":"1","key":"2019091011545922700_bib14","doi-asserted-by":"crossref","first-page":"348S","DOI":"10.3945\/ajcn.111.013441","article-title":"Biomarkers of cobalamin (vitamin B-12) status in the epidemiologic setting: a critical overview of context, applications, and performance characteristics of cobalamin, methylmalonic acid, and holotranscobalamin II","volume":"94","author":"Carmel","year":"2011","journal-title":"Am J Clin Nutr"},{"issue":"2","key":"2019091011545922700_bib15","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jdiacomp.2005.10.005","article-title":"Effects of metformin or rosiglitazone on serum concentrations of homocysteine, folate, and vitamin B12 in patients with type 2 diabetes mellitus","volume":"21","author":"Sahin","year":"2007","journal-title":"J Diabetes Complications"},{"issue":"1","key":"2019091011545922700_bib16","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1146\/annurev-nutr-071715-050947","article-title":"Homocysteine, B vitamins, and cognitive impairment","volume":"36","author":"Smith","year":"2016","journal-title":"Annu Rev Nutr"},{"issue":"2","key":"2019091011545922700_bib17","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1038\/nrendo.2010.228","article-title":"Cognitive function, dementia and type 2 diabetes mellitus in the elderly","volume":"7","author":"Strachan","year":"2011","journal-title":"Nat Rev Endocrinol"},{"key":"2019091011545922700_bib18","doi-asserted-by":"crossref","first-page":"549","DOI":"10.2147\/CIA.S74042","article-title":"Link between type 2 diabetes and Alzheimer\u2019s disease: from epidemiology to mechanism and treatment","volume":"10","author":"Li","year":"2015","journal-title":"Clin Interv Aging"},{"issue":"10","key":"2019091011545922700_bib19","doi-asserted-by":"crossref","first-page":"2981","DOI":"10.2337\/dc13-0229","article-title":"Increased risk of cognitive impairment in patients with diabetes is associated with metformin [published correction appears in Diabetes Care. 2013;36(11):3850\u20133850]","volume":"36","author":"Moore","year":"2013","journal-title":"Diabetes Care"},{"issue":"7","key":"2019091011545922700_bib20","doi-asserted-by":"crossref","first-page":"958","DOI":"10.2337\/dc16-2376","article-title":"Metformin, lifestyle intervention, and cognition in the diabetes prevention program outcomes study","volume":"40","author":"Luchsinger","year":"2017","journal-title":"Diabetes Care"},{"issue":"5","key":"2019091011545922700_bib21","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1210\/jc.2013-3507","article-title":"Vitamin D deficiency is associated with inflammation in older Irish adults","volume":"99","author":"Laird","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2019091011545922700_bib22","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1177\/0891988716666381","article-title":"The Frontal Assessment Battery: normative performance in a large sample of older community-dwelling hospital outpatient or general practitioner attenders","volume":"29","author":"Coen","year":"2016","journal-title":"J Geriatr Psychiatry Neurol"},{"issue":"4","key":"2019091011545922700_bib23","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1093\/clinchem\/45.4.569a","article-title":"Fully automated measurement of total homocysteine in plasma and serum on the Abbott IMx analyzer","volume":"45","author":"Leino","year":"1999","journal-title":"Clin Chem"},{"issue":"7","key":"2019091011545922700_bib24","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1136\/jcp.44.7.592","article-title":"Microbiological assay for vitamin B12 performed in 96-well microtitre plates","volume":"44","author":"Kelleher","year":"1991","journal-title":"J Clin Pathol"},{"issue":"3","key":"2019091011545922700_bib25","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1373\/clinchem.2007.096784","article-title":"Active B12: a rapid, automated assay for holotranscobalamin on the Abbott AxSYM analyzer","volume":"54","author":"Brady","year":"2008","journal-title":"Clin Chem"},{"issue":"8","key":"2019091011545922700_bib26","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1515\/cclm-2014-0818","article-title":"Combined indicator of vitamin B12 status: modification for missing biomarkers and folate status and recommendations for revised cut-points","volume":"53","author":"Fedosov","year":"2015","journal-title":"Clin Chem Lab Med"},{"key":"2019091011545922700_bib27","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0076-6879(97)81007-5","article-title":"Microbiological assay for serum, plasma, and red cell folate using cryopreserved, microtiter plate method","volume":"281","author":"Molloy","year":"1997","journal-title":"Methods Enzymol"},{"issue":"1-2","key":"2019091011545922700_bib28","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/S0009-8981(98)00173-9","article-title":"A simple, sensitive and reproducible assay for pyridoxal 5\u2032-phosphate and 4-pyridoxic acid in human plasma","volume":"280","author":"Bates","year":"1999","journal-title":"Clin Chim Acta"},{"issue":"6","key":"2019091011545922700_bib29","first-page":"413","article-title":"The relative effectiveness of iron and iron with riboflavin in correcting a microcytic anaemia in men and children in rural Gambia","volume":"37","author":"Powers","year":"1983","journal-title":"Hum Nutr Clin Nutr"},{"issue":"2","key":"2019091011545922700_bib30","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1093\/ajcn\/82.2.442","article-title":"Biochemical indicators of B vitamin status in the US population after folic acid fortification: results from the National Health and Nutrition Examination Survey 1999\u20132000","volume":"82","author":"Pfeiffer","year":"2005","journal-title":"Am J Clin Nutr"},{"issue":"6","key":"2019091011545922700_bib31","doi-asserted-by":"crossref","first-page":"e63544","DOI":"10.1371\/journal.pone.0063544","article-title":"Metabolomic analysis reveals extended metabolic consequences of marginal vitamin B-6 deficiency in healthy human subjects","volume":"8","author":"Gregory","year":"2013","journal-title":"PLoS One"},{"issue":"7","key":"2019091011545922700_bib32","doi-asserted-by":"crossref","first-page":"1636S","DOI":"10.3945\/jn.114.206599","article-title":"Biomarkers of nutrition for development-folate review","volume":"145","author":"Bailey","year":"2015","journal-title":"J Nutr"},{"key":"2019091011545922700_bib33","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":"2019091011545922700_bib34","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.2337\/dc18-S002","article-title":"Classification and diagnosis of diabetes: standards of medical care in diabetes\u20142018","volume":"41","author":"American Diabetes Association","year":"2018","journal-title":"Diabetes Care"},{"issue":"7","key":"2019091011545922700_bib35","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1111\/jgs.15258","article-title":"Effect of area\u2010level socioeconomic deprivation on risk of cognitive dysfunction in older adults","volume":"66","author":"McCann","year":"2018","journal-title":"J Am Geriatr Soc"},{"issue":"1","key":"2019091011545922700_bib36","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.diabres.2014.09.058","article-title":"Vitamin B status in patients with type 2 diabetes mellitus with and without incipient nephropathy","volume":"107","author":"Nix","year":"2015","journal-title":"Diabetes Res Clin Pract"},{"issue":"4","key":"2019091011545922700_bib37","first-page":"328","article-title":"Vitamins and trace metals status in non insulin dependent diabetes mellitus","volume":"61","author":"Havivi","year":"1991","journal-title":"Int J Vitam Nutr Res"},{"issue":"2","key":"2019091011545922700_bib38","doi-asserted-by":"crossref","first-page":"179","DOI":"10.4158\/EP11009.OR","article-title":"Effect of metformin therapy on vitamin D and vitamin B12 levels in patients with type 2 diabetes mellitus","volume":"18","author":"Kos","year":"2012","journal-title":"Endocr Pract"},{"issue":"2","key":"2019091011545922700_bib39","doi-asserted-by":"crossref","first-page":"327","DOI":"10.2337\/dc11-1582","article-title":"Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: the National Health and Nutrition Examination Survey, 1999\u20132006","volume":"35","author":"Reinstatler","year":"2012","journal-title":"Diabetes Care"},{"issue":"1","key":"2019091011545922700_bib40","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s00592-014-0597-8","article-title":"Influence of duration and dose of metformin on cobalamin deficiency in type 2 diabetes patients using metformin","volume":"52","author":"Beulens","year":"2015","journal-title":"Acta Diabetol"},{"issue":"2","key":"2019091011545922700_bib41","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1177\/0004563217747907","article-title":"Assessing biomarker status of vitamin B12 in the laboratory: no simple solution","volume":"55","author":"Hughes","year":"2018","journal-title":"Ann Clin Biochem"},{"issue":"9","key":"2019091011545922700_bib42","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"},{"issue":"5","key":"2019091011545922700_bib43","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1016\/j.biochi.2012.10.028","article-title":"Serum vitamin B12 not reflecting vitamin B12 status in patients with type 2 diabetes","volume":"95","author":"Obeid","year":"2013","journal-title":"Biochimie"},{"issue":"3","key":"2019091011545922700_bib44","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s40618-015-0365-9","article-title":"Diabetic neuropathy is not associated with homocysteine, folate, vitamin B12 levels, and MTHFR C677T mutation in type 2 diabetic outpatients taking metformin","volume":"39","author":"Russo","year":"2016","journal-title":"J Endocrinol Invest"},{"issue":"may19 4","key":"2019091011545922700_bib45","doi-asserted-by":"crossref","first-page":"c2181","DOI":"10.1136\/bmj.c2181","article-title":"Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial","volume":"340","author":"de Jager","year":"2010","journal-title":"BMJ"},{"issue":"5","key":"2019091011545922700_bib46","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1046\/j.1365-2796.2003.01213.x","article-title":"Effects of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomized, placebo-controlled trial","volume":"254","author":"Wulffel\u00e9","year":"2003","journal-title":"J Intern Med"},{"issue":"12","key":"2019091011545922700_bib47","doi-asserted-by":"crossref","first-page":"798","DOI":"10.3390\/nu8120798","article-title":"Metformin treatment and homocysteine: a systematic review and meta-analysis of randomized controlled trials","volume":"8","author":"Zhang","year":"2016","journal-title":"Nutrients"},{"issue":"8","key":"2019091011545922700_bib48","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1002\/gps.698","article-title":"The distribution of Mini-Mental State Examination scores in an older UK African-Caribbean population compared to MRC CFA study norms","volume":"17","author":"Stewart","year":"2002","journal-title":"Int J Geriatr Psychiatry"},{"issue":"1","key":"2019091011545922700_bib49","doi-asserted-by":"crossref","first-page":"e87095","DOI":"10.1371\/journal.pone.0087095","article-title":"Diabetes mellitus and the risk of Alzheimer\u2019s disease: a nationwide population-based study","volume":"9","author":"Huang","year":"2014","journal-title":"PLoS One"},{"issue":"10","key":"2019091011545922700_bib50","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1093\/gerona\/glu073","article-title":"Type 2 diabetes and antidiabetic medications in relation to dementia diagnosis","volume":"69","author":"Cheng","year":"2014","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"1","key":"2019091011545922700_bib51","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S1474-4422(05)70284-2","article-title":"Risk of dementia in diabetes mellitus: a systematic review","volume":"5","author":"Biessels","year":"2006","journal-title":"Lancet Neurol"},{"issue":"3","key":"2019091011545922700_bib52","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1038\/nrneurol.2017.185","article-title":"Brain insulin resistance in type 2 diabetes and Alzheimer disease: concepts and conundrums","volume":"14","author":"Arnold","year":"2018","journal-title":"Nat Rev Neurol"},{"issue":"5","key":"2019091011545922700_bib53","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/j.1463-1326.2008.00963.x","article-title":"The role of metabolic derangements and glucocorticoid excess in the aetiology of cognitive impairment in type 2 diabetes. Implications for future therapeutic strategies","volume":"11","author":"Strachan","year":"2009","journal-title":"Diabetes Obes Metab"},{"issue":"10","key":"2019091011545922700_bib54","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1093\/aje\/kwn229","article-title":"Association of adiposity status and changes in early to mid-adulthood with incidence of Alzheimer\u2019s disease","volume":"168","author":"Beydoun","year":"2008","journal-title":"Am J Epidemiol"},{"issue":"11","key":"2019091011545922700_bib55","doi-asserted-by":"crossref","first-page":"725","DOI":"10.3390\/nu8110725","article-title":"Causes, consequences and public health implications of low B-vitamin status in ageing","volume":"8","author":"Porter","year":"2016","journal-title":"Nutrients"},{"issue":"9","key":"2019091011545922700_bib56","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1007\/s12603-017-0979-z","article-title":"High serum folate is associated with brain atrophy in older diabetic people with vitamin B12 deficiency","volume":"21","author":"Deng","year":"2017","journal-title":"J Nutr Health Aging"},{"issue":"5","key":"2019091011545922700_bib57","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1093\/ajcn\/86.5.1405","article-title":"Effect of a voluntary food fortification policy on folate, related B vitamin status, and homocysteine in healthy adults","volume":"86","author":"Hoey","year":"2007","journal-title":"Am J Clin Nutr"},{"issue":"6","key":"2019091011545922700_bib58","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.3945\/ajcn.115.107151","article-title":"Impact of voluntary fortification and supplement use on dietary intakes and biomarker status of folate and vitamin B-12 in Irish adults","volume":"101","author":"Hopkins","year":"2015","journal-title":"Am J Clin Nutr"},{"issue":"6","key":"2019091011545922700_bib59","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.3945\/ajcn.116.151241","article-title":"Circulating concentrations of biomarkers and metabolites related to vitamin status, one-carbon and the kynurenine pathways in US, Nordic, Asian, and Australian populations","volume":"105","author":"Midttun","year":"2017","journal-title":"Am J Clin Nutr"},{"issue":"2","key":"2019091011545922700_bib60","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1093\/ajcn\/68.2.328","article-title":"Role of cobalamin intake and atrophic gastritis in mild cobalamin deficiency in older Dutch subjects","volume":"68","author":"van Asselt","year":"1998","journal-title":"Am J Clin Nutr"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/104\/10\/4837\/29643063\/jc.2018-01791.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T23:56:55Z","timestamp":1694735815000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/104\/10\/4837\/5421021"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,28]]},"references-count":60,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,10,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2018-01791","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,10]]},"published":{"date-parts":[[2019,3,28]]}}}