Summary
The present investigation was carried out to ascertain whether parenteral biguanides cause vitamin B12 malabsorption. Secondly, to evaluate whether the biguanides, either orally or parenterally, cause bile acid malabsorption. Five groups of guinea pigs were given either saline, phenformin or metformin subcutaneously or orally. At intervals, the dosage was changed and B12 absorption was estimated using Co58B12. Bile acid excretion was estimated using C14 cholic acid. The results suggest that parenteral and oral biguanides cause both B12 and bile acid malabsorption.
These results have been discussed in relation to the mechanism of action of the biguanides. The implications on the formation of lithogenic bile and gallstones and the effect on cholesterol metabolism appear to need further evaluation.
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References
Abaurre, R., Gordon, S. G., Mann, J. G. and Kern, F. 1969. Fasting bile salt pool size and composition after ileal resection. Gastroenterology 57, 679.
Agid, R. and Marquit, G. 1972. Effets inhibiteurs de certains biguanides antidiabetiques sur l’absorption ntestinale des lipides. C. R. Acad. Sci. (Paris) 275, 1787.
Beckman, R. 1968. The fate of biguanides in man. Ann. N.Y. Acad. Sci. 148, 820.
Beckman, R. 1969. Resorption, Verteilung im Organismus und Ausscheidung von Metformin. Diabetologia 5, 318.
Caspary, W. F. and Creutzfeldt, W. 1973. Inhibition of intestinal amino acid transport by blood sugar lowering biguanides. Diabetologia 11, 113.
Czyzyk, A., Tawecki, J., Sadowski, J., Ponikowska, J. and Szezepanik, Z. 1968. Effect of biguanides on intestinal absorption of glucose. Diabetes 17, 492.
Davidoff, F. 1971. Effect of guanide derivatives on mitochondrial function. J. biol. Chem. 246, 4017.
Dowling, R. H., Mack, E. and Small, D. M. 1970. Effects of controlled interruption of the enterohepatic circulation of bile salts by diversion and by ileal resection or mile salt secretion, synthesis and pool size in the rhesus monkey. J. clin. Invest. 49, 232.
Heaton, K. W., Austad, W. I., Lack, L. and Tyor, M. P. 1968. Enterchepatic circulation of C14 labelled bile salts in disorders of the distal small bowel. Gastroenterology 55, 5.
Heaton, K. W. and Read, A. E. 1969. Gallstones in patients with disorders of the terminal ileum and disturbed bile sait metabolism. Brit. med. J. iii, 494.
Hollobaugh, S. L., Bhaska Rao, M. and Kruger, F. A. Studies on the site and mechanism of action of phenformin. Diabetes 19, 45.
Kahan, M., Hirshleifer, I and Mandel, E. E. 1966. Serum lipids in diabetes mellitus: a comparison of the effects of tolbutamide, phenformin-hydrochloride and NPH-insulin. Diabetes 15, 536.
Schwartz, M. J., Mirsky, S. and Schaefer, L. E. 1966. The effect of phenformin; hydrochloride on serum cholesterol and triglyceride levels of the stable adult diabetic. Metabolism 15, 808.
The University Group Diabetes Program. 1972. V. Evaluation of phenformin therapy. Diabetes 24, Suppl. 1, 105.
Tomkin, G. H. 1973. Malabsorption of vitamin B12 in diabetic patients treated with phenformin: a comparison with metformin. Brit. med. J. iii, 673.
Tomkin, G. H., Hadden, D. R., Weaver, J. and Montgomery, D. A. D. 1971. Vitamin B12 status of patients on long term metformin therapy. Brit. med. J. ii, 685.
Van de Kamer, J. H., H. ten Bokkel Huinink and Weyers, H. A. 1949. Rapid method for the determination of fat in faeces. J. biolfl Chem. 177, 347.
Vlancevic, Z. R., Bell, C. C., Buhac, I., Farrar, J. T. and Swell, L. 1970. Diminished bile acid pool size in patients with gallstones. Gastroenterology 59, 165.
Vlahcevic, Z. R., Miller, J. R., Farrar, J. T. and Swell, L. 1971. Kinetics and pool size of primary bile acids in man. Gastroenterology 61, 85.
Weber, A. M., Chartrand, L., Doyon, G., Gordon, S. and Roy, C. C. 1972. The quantitative determination of faecal bile acids in children by the enzymatic method. Clin. chim. Acta 39, 524.
Wick, A. N., Larson, E. and Serif, G. S. 1958. A site of action of phenethylbiguanide, a hypoglycaemic compound. J. biol. Chem. 233, 296.
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Tomkin, G.H. Comparison of the effect of parenteral with oral biguanide therapy on vitamin B12 and bile acid absorption. IJMS 145, 340–347 (1976). https://doi.org/10.1007/BF02938968
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DOI: https://doi.org/10.1007/BF02938968