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- Title
Metformin reduces circulating malondialdehyde-modified lowdensity lipoprotein in type 2 diabetes mellitus.
- Authors
Masahiro Ohira; Takashi Yamaguchi; Atsuhito Saiki; Noriko Ban; Hidetoshi Kawana; Daiji Nagayama; Ayako Nagumo; Takeyoshi Murano; Kohji Shirai; Ichiro Tatsuno
- Abstract
Purpose: Type 2 diabetes is known to be associated with increasing cardiovascular mortality. Malondialdehyde-modified LDL (MDA-LDL) is an oxidized LDL and is increased in patients with diabetes or hypertriglyceridemia. Elevated MDA-LDL has been reported to be a risk factor of atherosclerosis or cardiovascular disease. Sitagliptin is a dipeptidyl peptidase-4 inhibitor and a new class of hypoglycemic agents. In this study, the effects of increasing the dose of metformin and add-on sitagliptin on MDA-LDL were examined in type 2 diabetes patients. Methods: Seventy patients with type 2 diabetes, inadequately controlled despite on-going treatment with metformin 500 mg/day, were enrolled in this randomized controlled trial. The patients received additional metformin (500 mg/day) or sitagliptin (50 mg/day) for 6 months, and changes in metabolic parameters including MDA-LDL were evaluated. Results: After 6 months of treatment, add-on sitagliptin (n=35) improved fasting blood glucose (FBG) and hemoglobin A1c (HbA1c) to significantly greater extent than increasing the dose of metformin (n=35). There were no differences in total cholesterol and lowdensity lipoprotein cholesterol levels between two groups. MDA-LDL levels (mean±S.E.) decreased significantly with increasing the dose of metformin (from 94.40±6.35 to 77.83±4.74 U/L, P<0.005), but remained unchanged with add-on sitagliptin treatment (from 89.94±5.59 to 98.46±6.78 U/L, p>0.05). Multiple linear regression analysis identified increasing the dose of metformin treatment as the only independent factor associated with decreased MDA-LDL (ß coefficient 0.367, P<0.0119), and no significant correlation between change in MDA-LDL and fasting blood glucose or HbA1c. Conclusion: These results suggest that increasing the dose of metformin improves serum MDA-LDL levels in type 2 diabetes mellitus.
- Subjects
TYPE 2 diabetes treatment; MALONDIALDEHYDE; LOW density lipoproteins; SITAGLIPTIN; METFORMIN; HYPERTRIGLYCERIDEMIA; CARDIOVASCULAR diseases risk factors; THERAPEUTICS
- Publication
Clinical & Investigative Medicine, 2014, Vol 37, Issue 4, pE243
- ISSN
0147-958X
- Publication type
Article
- DOI
10.25011/cim.v37i4.21730