PT - JOURNAL ARTICLE AU - Lishun Liu AU - Xiao Huang AU - Binyan Wang AU - Yun Song AU - Tengfei Lin AU - Ziyi Zhou AU - Zhuo Wang AU - Yaping Wei AU - Huiyuan Guo AU - Ping Chen AU - Yan Yang AU - Wenhua Ling AU - Youbao Li AU - Xianhui Qin AU - Genfu Tang AU - Chengzhang Liu AU - Jianping Li AU - Yan Zhang AU - Pierre A Zalloua AU - Xiaobin Wang AU - Yong Huo AU - Hao Zhang AU - Xiping Xu TI - Vitamin B<sub>12</sub> and risk of diabetes: new insight from cross-sectional and longitudinal analyses of the China Stroke Primary Prevention Trial (CSPPT) AID - 10.1136/bmjdrc-2020-001423 DP - 2020 Oct 01 TA - BMJ Open Diabetes Research &amp; Care PG - e001423 VI - 8 IP - 1 4099 - http://drc.bmj.com/content/8/1/e001423.short 4100 - http://drc.bmj.com/content/8/1/e001423.full SO - BMJ Open Diab Res Care2020 Oct 01; 8 AB - Introduction Previous studies in mostly Western populations have yielded conflicting findings on the association of vitamin B12 with diabetes risk, in part due to differences in study design and population characteristics. This study sought to examine the vitamin B12–diabetes association in Chinese adults with hypertension by both cross-sectional and longitudinal analyses.Research design and methods This report included a total of 16 699 participants from the China Stroke Primary Prevention Trial, with pertinent baseline and follow-up data. Diabetes mellitus was defined as either physician-diagnosed diabetes, use of glucose-lowering drugs, or fasting blood glucose (FBG) ≥7.0 mmol/L. New-onset diabetes was defined as any new case of onset diabetes during the follow-up period or FBG ≥7.0 mmol/L at the exit visit.Results At baseline, there were 1872 (11.2%) patients with diabetes; less than 1.5% had clinical vitamin B12 deficiency (&lt;148.0 pmol/L). Over a median follow-up period of 4.5 years, there were 1589 (10.7%) cases of new-onset diabetes. Cross-sectional analyses showed a positive association between baseline vitamin B12 levels and FBG levels (β=0.18, 95% CI 0.15 to 0.21) and diabetes (OR=1.16, 95% CI 1.10 to 1.21). However, longitudinal analyses showed no association between baseline vitamin B12 and new-onset diabetes or changes in FBG levels. Among a subset of the sample (n=4366) with both baseline and exit vitamin B12 measurements, we found a positive association between an increase in vitamin B12 and an increase in FBG.Conclusions In this large Chinese population of patients with hypertension mostly sufficient with vitamin B12, parallel cross-sectional and longitudinal analyses provided new insight into the conflicting findings of previous studies, and these results underscore the need for future studies to consider both baseline vitamin B12 and its longitudinal trajectory in order to better elucidate the role of vitamin B12 in the development of diabetes. Such findings would have important clinical and public health implications.