Meeting News

Vitamin B supplementation may prevent nephropathy progression in children with type 1 diabetes

Children with type 1 diabetes, vitamin B12 deficiency and nephropathy assigned to 12 weeks of vitamin B supplementation experienced improvements in markers of renal disease and inflammation vs. those receiving usual care, suggesting the intervention may have a protective effect, according to findings presented at the European Society for Paediatric Endocrinology annual meeting.

Nancy Samir Elbarbary

“Oral vitamin B complex supplementation once daily as an adjuvant therapy to [angiotensin-converting enzyme] inhibitor therapy is safe, well-tolerated and may have a nephroprotective action in children and adolescents with diabetic nephropathy,” Nancy Samir Elbarbary, MD, professor in the department of pediatrics at Ain Shams University in Cairo, told Endocrine Today. “Vitamin B supplementation was associated with decreased levels of homocysteine, albuminuria and markers of inflammation, such as cystatin C. Therefore, it could prevent the progression of diabetic nephropathy. Moreover, it has a role in the regulation of blood glucose homeostasis, as reflected by lowering blood glucose and HbA1c, as well as improving dyslipidemia.”

Elbarbary and colleagues analyzed data from 80 children aged 12 to 18 years with type 1 diabetes, vitamin B12 deficiency and nephropathy that persisted despite angiotensin-converting enzyme inhibitor therapy. Researchers randomly assigned patients to once-daily oral vitamin B supplementation (consisting of 200 mg vitamin B1, 50 mg vitamin B6 and 1,000 µg vitamin B12) or a control group receiving usual care for 12 weeks. Researchers measured levels of plasma homocysteine, HbA1c, urinary albumin excretion and cystalin C.

At 12 weeks, children assigned to vitamin B supplementation saw decreases in plasma homocysteine, fasting blood glucose, HbA1c, total cholesterol, triglycerides, urinary albumin excretion and cystatin C vs. their baseline levels (P < .001) and against the control group (P < .001). Baseline vitamin B12 level was negatively correlated with urinary albumin excretion (r = –0.877; P = .009) and cystalin C (r = –0.77; P = .043) and was negatively correlated with homocysteine levels in children assigned to supplementation, according to the researchers.

“There is a high prevalence of vitamin B complex deficiency among patients with type 1 diabetes that is connected to diabetic nephropathy,” Elbarbary said. “It would be pragmatic to screen for it in the presence of any clinical manifestations to avoid diabetic microvascular complications.” – by Regina Schaffer

Reference:

Elbarbary NS, et al. Abstract FC 12.5. Presented at: European Society for Paediatric Endocrinology Meeting; Sept. 27-29, 2018; Athens, Greece.

For more information:

Nancy Samir Elbarbary , MD, can be reached at Ain Shams University, 38 Abbasid Next Nour Mosque Cairo Governorate, Egypt; email: Nancy_elbarbary@yahoo.com.

Disclosure: Elbarbary reports no relevant financial disclosures.

Children with type 1 diabetes, vitamin B12 deficiency and nephropathy assigned to 12 weeks of vitamin B supplementation experienced improvements in markers of renal disease and inflammation vs. those receiving usual care, suggesting the intervention may have a protective effect, according to findings presented at the European Society for Paediatric Endocrinology annual meeting.

Nancy Samir Elbarbary

“Oral vitamin B complex supplementation once daily as an adjuvant therapy to [angiotensin-converting enzyme] inhibitor therapy is safe, well-tolerated and may have a nephroprotective action in children and adolescents with diabetic nephropathy,” Nancy Samir Elbarbary, MD, professor in the department of pediatrics at Ain Shams University in Cairo, told Endocrine Today. “Vitamin B supplementation was associated with decreased levels of homocysteine, albuminuria and markers of inflammation, such as cystatin C. Therefore, it could prevent the progression of diabetic nephropathy. Moreover, it has a role in the regulation of blood glucose homeostasis, as reflected by lowering blood glucose and HbA1c, as well as improving dyslipidemia.”

Elbarbary and colleagues analyzed data from 80 children aged 12 to 18 years with type 1 diabetes, vitamin B12 deficiency and nephropathy that persisted despite angiotensin-converting enzyme inhibitor therapy. Researchers randomly assigned patients to once-daily oral vitamin B supplementation (consisting of 200 mg vitamin B1, 50 mg vitamin B6 and 1,000 µg vitamin B12) or a control group receiving usual care for 12 weeks. Researchers measured levels of plasma homocysteine, HbA1c, urinary albumin excretion and cystalin C.

At 12 weeks, children assigned to vitamin B supplementation saw decreases in plasma homocysteine, fasting blood glucose, HbA1c, total cholesterol, triglycerides, urinary albumin excretion and cystatin C vs. their baseline levels (P < .001) and against the control group (P < .001). Baseline vitamin B12 level was negatively correlated with urinary albumin excretion (r = –0.877; P = .009) and cystalin C (r = –0.77; P = .043) and was negatively correlated with homocysteine levels in children assigned to supplementation, according to the researchers.

“There is a high prevalence of vitamin B complex deficiency among patients with type 1 diabetes that is connected to diabetic nephropathy,” Elbarbary said. “It would be pragmatic to screen for it in the presence of any clinical manifestations to avoid diabetic microvascular complications.” – by Regina Schaffer

Reference:

Elbarbary NS, et al. Abstract FC 12.5. Presented at: European Society for Paediatric Endocrinology Meeting; Sept. 27-29, 2018; Athens, Greece.

For more information:

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Nancy Samir Elbarbary , MD, can be reached at Ain Shams University, 38 Abbasid Next Nour Mosque Cairo Governorate, Egypt; email: Nancy_elbarbary@yahoo.com.

Disclosure: Elbarbary reports no relevant financial disclosures.