{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:03:08Z","timestamp":1763643788710,"version":"build-2065373602"},"reference-count":58,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Isoplus","award":["Metformin"],"award-info":[{"award-number":["Metformin"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The International Society of Pediatric and Adolescent Diabetes (ISPAD) recommends metformin (MET) use for metabolic disturbances and hyperglycemia, either in combination with insulin therapy or alone. A caveat of MET therapy has been suggested to be biochemical vitamin B12 deficiency, as seen mainly in studies conducted in adults. In the present case\u2013control study, children and adolescents of different weight status tiers on MET therapy for a median of 17 months formed the cases group (n = 23) and were compared with their peers not taking MET (n = 46). Anthropometry, dietary intake, and blood assays were recorded for both groups. MET group members were older, heavier, and taller compared with the controls, although BMI z-scores did not differ. In parallel, blood phosphorus and alkaline phosphatase (ALP) concentrations were lower in the MET group, whereas MCV, \u03944-androstenedione, and DHEA-S were higher. No differences were observed in the HOMA-IR, SHBG, hemoglobin, HbA1c, vitamin B12, or serum 25(OH)D3 concentrations between groups. Among those on MET, 17.4% exhibited vitamin B12 deficiency, whereas none of the controls had low vitamin B12 concentrations. Participants on MET therapy consumed less energy concerning their requirements, less vitamin B12, more carbohydrates (as a percentage of the energy intake), and fewer fats (including saturated and trans fats) compared with their peers not on MET. None of the children received oral nutrient supplements with vitamin B12. The results suggest that, in children and adolescents on MET therapy, the dietary intake of vitamin B12 is suboptimal, with the median coverage reaching 54% of the age- and sex-specific recommended daily allowance. This low dietary intake, paired with MET, may act synergistically in reducing the circulating vitamin B12 concentrations. Thus, caution is required when prescribing MET in children and adolescents, and replacement is warranted.<\/jats:p>","DOI":"10.3390\/ijms24044205","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T04:28:57Z","timestamp":1676867337000},"page":"4205","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Serum Concentrations and Dietary Intake of Vitamin B12 in Children and Adolescents on Metformin: A Case\u2013Control Study"],"prefix":"10.3390","volume":"24","author":[{"given":"Kyriaki","family":"Tsiroukidou","sequence":"first","affiliation":[{"name":"3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3453-3986","authenticated-orcid":false,"given":"Eleni G.","family":"Paschalidou","sequence":"additional","affiliation":[{"name":"3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4167-6595","authenticated-orcid":false,"given":"Maria G.","family":"Grammatikopoulou","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Androulakis","sequence":"additional","affiliation":[{"name":"IsoPlus, Scientific Department, 236 Syggrou Avenue, GR-17672 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8101-0857","authenticated-orcid":false,"given":"Anastasios","family":"Vamvakis","sequence":"additional","affiliation":[{"name":"3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece"},{"name":"Department of Nutrition and Dietetics, Sciences School of Health Science, Hellenic Mediterranean University, GR-71410 Heraklion, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalliopi K.","family":"Gkouskou","sequence":"additional","affiliation":[{"name":"Laboratory of Biology, School of Medicine, National and Kapodistrian University of Athens, GR-11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2842-2320","authenticated-orcid":false,"given":"Christos","family":"Tzimos","sequence":"additional","affiliation":[{"name":"Northern Greece Statistics Directorate, Hellenic Statistical Authority, 218 Delfon Str., GR-54646 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9355-5528","authenticated-orcid":false,"given":"Theodoros N.","family":"Sergentanis","sequence":"additional","affiliation":[{"name":"Department of Public Health Policy, School of Public Health, University of West Attica, GR-11521 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9993-1897","authenticated-orcid":false,"given":"Tonia","family":"Vassilakou","sequence":"additional","affiliation":[{"name":"Department of Public Health Policy, School of Public Health, University of West Attica, GR-11521 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0202-364X","authenticated-orcid":false,"given":"Emmanuel","family":"Roilides","sequence":"additional","affiliation":[{"name":"3rd Department of Pediatrics, Hippokration General Hospital of Thessaloniki, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9697-7902","authenticated-orcid":false,"given":"Dimitrios P.","family":"Bogdanos","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5005-1995","authenticated-orcid":false,"given":"Dimitrios 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