ArticleDiabetes care2022
Cobalamin Intake and Related Biomarkers: Examining Associations With Mortality Risk Among Adults With Type 2 Diabetes in NHANES.
Article in Diabetes care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 1 of them a synthesis that pooled it.
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Who cites it
38 citing papers in PubMed, 1 synthesis or guideline pooled it, 77 citations in OpenAlex.
- The Controversial Issue of Hypervitaminosis B12 as Prognostic Factor of Mortality: Global Lessons from a Systematic Review and Meta-Analysis.Nutrients · 2025Pooled it
- Physical Activity and Macular Choroidal Circulation in Older Adults With Primary Open-Angle Glaucoma: A Swept-Source Optical Coherence Tomography Angiography Study.Translational vision science & technology · 2026Article
- Sleep Pattern and Structural Damage in Older Adults with Glaucoma: A United States and China Study.Ophthalmology science · 2026Article
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- Why Do I Need Sleep? Exploring Children's Views on Sleep and Its Importance.Healthcare (Basel, Switzerland) · 2026Article
- Elevated methylmalonic acid, but not vitamin B12, predicts all-cause mortality in hyperlipidemic adults: a prospective cohort study.Frontiers in nutrition · 2026Article
- Methylmalonate accumulation contributes to myocardial vulnerability post-reperfusion: a novel therapeutic target and prognostic biomarker.BMC medicine · 2025Article
- HDL-C and systemic inflammatory response index mediate the association between visceral adipose tissue and risk of cardiovascular disease among young and middle-aged adults with prediabetes or diabetes: a national cohort study.Journal of translational medicine · 2025Article
- The Role of Methylmalonic Acid in the Risk of Sarcopenia and All-Cause Mortality Among Individuals With Sarcopenia: Evidence From NHANES.Food science & nutrition · 2025Article
- Hemoglobin-to-Red Cell Distribution Width Ratio Was Associated with Cardiovascular Diseases and Death.Journal of clinical medicine · 2025Article
- Sleep habits, brain functional networks, and type 2 diabetes risk: cohort studies from North American and Asian populations and mediating Mendelian randomization analyses.Diabetology & metabolic syndrome · 2025Article
- Non-linear association of a novel inflammation-lipid composite marker CRP/HDL with insulin resistance and type 2 diabetes: findings from a comprehensive national cross-sectional study.Diabetology & metabolic syndrome · 2025Article
- Opposite outcomes of triglyceride-glucose index and associated cardiovascular mortality risk in type 2 diabetes mellitus participants by different obesity criteria.Scientific reports · 2025Article
- Mitochondrial dysfunction-related metabolite methylmalonic acid is associated with decreased cognitive performance.PloS one · 2025Article
- Sex-specific differences in the association of dietary riboflavin intake with depression and suicidal ideation.Frontiers in nutrition · 2025Article
- Evaluating causal influence of serum uric acid on psoriasis via observational study and transethnic Mendelian randomization analyses.Scientific reports · 2024Observational
- The independent and joint associations of vitamin B12 and methylmalonic acid on the risk of mortality in individuals with metabolic dysfunction-associated steatotic liver disease.European journal of nutrition · 2024Article
- Association between oxidative balance scores and all-cause and cardiovascular disease-related mortality in patients with type 2 diabetes: data from the national health and nutrition examination survey (2007-2018).BMC public health · 2024Article
- Association between weekend warrior physical activity pattern and all-cause mortality among adults living with type 2 diabetes: a prospective cohort study from NHANES 2007 to 2018.Diabetology & metabolic syndrome · 2024Article
- Homocysteine Metabolism, Subclinical Myocardial Injury, and Cardiovascular Mortality in the General Population.JACC. Asia · 2024Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveDespite that periodical monitoring of cobalamin (vitamin B12) in metformin-treated patients with diabetes is recommended, cobalamin-associated mortality benefits or risks remain unclear. We investigated the association between cobalamin intake and related biomarkers and mortality risk in adults with diabetes using metformin or not. RESEARCH DESIGN AND
methodsThis study included 3,277 adults with type 2 diabetes from the National Health and Nutrition Examination Survey (NHANES) and followed up until 31 December 2015. Weighted Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs for mortality risk.
resultsAmong 3,277 participants, 865 all-cause deaths occurred during a median follow-up of 7.02 years. There was no robust relationship between all-cause mortality and serum cobalamin or intake of foods or cobalamin supplements, regardless of metformin treatment (each P ≥ 0.120). The doubling of methylmalonic acid (MMA), a cobalamin-deficiency marker, was significantly associated with higher all-cause (HR 1.31 [95% CI 1.18-1.45], P < 0.001) and cardiac (HR 1.38 [95% CI 1.14-1.67], P = 0.001) mortality. Cobalamin sensitivity was assessed by the combination of binary B12low/high and MMAlow/high (cutoff values: cobalamin 400 pg/mL, MMA 250 nmol/L). Patients with decreased cobalamin sensitivity (MMAhighB12high) had the highest mortality risk. The multivariable-adjusted HRs (95% CIs) of all-cause mortality in MMAlowB12low, MMAlowB12high, MMAhighB12low, and MMAhighB12high groups were 1.00 (reference), 0.98 (0.75-1.28), 1.49 (1.16-1.92), and 1.96 (1.38-2.78), respectively. That association was especially significant in metformin nonusers.
conclusionsSerum and dietary cobalamin were not associated with reduced mortality. Decreased cobalamin sensitivity was significantly associated with all-cause and cardiac mortality, particularly among metformin nonusers.
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