Effect of metformin on oxidative stress, nitrosative stress and inflammatory biomarkers in type 2 diabetes patients

Aim: Advanced research has radically changed both diagnosis and treatment of diabetes during last three decades; a number of classes of oral antidiabetic agents are currently available for better glycemic control. Present study aims to evaluate the effect of metformin on different stress and inflammatory parameters in diabetic subjects. Methods: 208 type 2 diabetes patients were randomly assigned for metformin and placebo. Results: Reactive oxygen species generation, advanced oxidation protein products (179.65 +/- 13.6, 120.65 +/- 10.5 mmol/l) and pentosidine (107 +/- 10.4, 78 +/- 7.6 pmol/ml) were found to be reduced by metformin treatment compared to placebo. On the other hand metformin administration enhanced total thiol and nitric oxide level (p < 0.05). But nutrient level (Mg+2, Ca+2) in plasma was not altered by the treatment. Significant restoration of C reactive protein (p < 0.05) was noticed after metformin therapy. Metformin administration also improved Na+K+ ATPase activity (0.28 +/- 0.08, 0.41 +/- 0.07 mu mol Pi/mg/h) in erythrocyte membrane. Conclusions: This study explores that metformin treatment restores the antioxidant status, enzymatic activity and inflammatory parameters in type 2 diabetic patients. Metformin therapy improves the status of oxidative and nitrosative stress altered in type 2 diabetes. This study unfolds the cardio protective role of metformin as an oral hypoglycemic agent. (C) 2010 Elsevier Ireland Ltd. All rights reserved.