Abstract
BackgroundMetformin has been used for the treatment of type 2 diabetes by suppressing hepatic gluconeogenesis. It has been shown that the subclinical inflammatory responses play important roles in the pathogenesis of type 2 diabetes. In the present study, we determined the effects of metformin on the levels of pro-inflammatory cytokines (i.e., IL-6, TNF-α, and MCP-1) and anti-inflammatory mediator IL-10 in blood and urine of patients with type 2 diabetes. There were 210 patients with type 2 diabetes, which were randomized into metformin (n = 112) and non-metformin (gliclazide, acarbose, and repaglinide, n = 98) groups. The levels of cytokines were measured by the ELISA.ResultsWe found that metformin reduced the levels of IL-6 in blood and MCP-1 in urine, but increased IL-10 levels in blood of patients with type 2 diabetes. There were no significant differences of TNF-α between metformin and non-metformin groups. Furthermore, compared to individual drug treatment, metformin significantly reduced the levels of serum IL-6 and TNF-α, as well as urine MCP-1. When the patients were stratified based on the durations and doses of metformin, we found that there was only change (i.e., increase) in serum IL-10 levels in patients with metformin for more than 1 year compared to treatment for less than 1 year. Metformin (1.5 g) treatment reduced the urinary levels of MCP-1 as compared with dose of 1.0 g in patients with type 2 diabetes.ConclusionMetformin reduces inflammatory responses without influence on renal function in type 2 diabetic patients.
Highlights
Metformin has been used for the treatment of type 2 diabetes by suppressing hepatic gluconeogenesis
We found that there were no significant differences in levels of tumor necrosis factor (TNF)-α or IL-10 in serum between metformin and non-metformin treated type 2 diabetic patients
We found that there were no effects of serum IL-6, IL10, or TNF-α between 1000 and 1500 mg treatments with metformin in type 2 diabetic patients (Fig. 3)
Summary
Metformin has been used for the treatment of type 2 diabetes by suppressing hepatic gluconeogenesis. We determined the effects of metformin on the levels of pro-inflammatory cytokines (i.e., IL-6, TNF-α, and MCP-1) and anti-inflammatory mediator IL-10 in blood and urine of patients with type 2 diabetes. It has been suggested that metformin improves metabolic parameters such as hyperglycemia, insulin resistance and atherogenic dyslipidemia, thereby reducing chronic inflammatory responses [14, 15] It is not clear whether metformin has any effects on inflammatory responses in the systemic circulation and urine of patients with type 2 diabetes. We determined the effects of metformin with different doses and durations on the levels of pro-inflammatory cytokines (i.e., IL-6, TNF-α, and MCP-1) and antiinflammatory mediator IL-10 in blood and urine of patients with type 2 diabetes
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