title: Effects of metformin on markers of oxidative stress and antioxidant reserve in patients with newly diagnosed type 2 diabetes: a randomized clinical trial.
abstract: OBJECTIVE
  Given the long term benefits observed with metformin use in diabetes patients, a role in modulating oxidative stress is imputable. Effects of metformin on markers of oxidative stress, antioxidant reserve, and HDL-c associated antioxidant enzymes were investigated.
  
  
  METHODS
  In a clinical trial setting (Registered under Clinical Trials.gov Identifier no. NCT01521624) 99 medication-naïve, newly diagnosed type 2 diabetes patients were randomly assigned to either metformin or lifestyle modification. AOPP, AGE, FRAP, activities of LCAT, and PON were measured at baseline and after 12-weeks.
  
  
  RESULTS
  Baseline values of the oxidative stress markers did not differ significantly between the two groups. In cases, after three months treatment, there was a significant reduction in AOPP (137.52 ± 25.59, 118.45 ± 38.42, p < 0.001), and AGE (69.28 ± 4.58, 64.31 ± 8.64, p = 0.002). FRAP and PON increased significantly (1060.67 ± 226.69, 1347.80 ± 251.40, p < 0.001 and 29.85 ± 23.18, 37.86 ± 27.60, p = 0.012 respectively). LCAT levels remained unchanged (45.23 ± 4.95, 46.15 ± 6.28, p = 0.439). Comparing the two groups in a final multivariate model, AOPP, FRAP, and AGE levels changed more significantly in metformin compared with lifestyle modification alone (p = 0.007, p < 0.001 and p < 0.001 respectively). Escalation in LCAT or PON activities did not differ between the two groups (p = 0.199 and 0.843 respectively).
  
  
  CONCLUSIONS
  Use of metformin is more effective in reducing oxidative stress compared with lifestyle modification alone.
authors.affiliation: Endocrinology and Metabolism Research Center, Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. esteghamati@tums.ac.ir
authors.forename: Alireza
authors.initials: A
authors.lastname: Esteghamati
authors.forename: Delaram
authors.initials: D
authors.lastname: Eskandari
authors.forename: Hossein
authors.initials: H
authors.lastname: Mirmiranpour
authors.forename: Sina
authors.initials: S
authors.lastname: Noshad
authors.forename: Mostafa
authors.initials: M
authors.lastname: Mousavizadeh
authors.forename: Mehdi
authors.initials: M
authors.lastname: Hedayati
authors.forename: Manouchehr
authors.initials: M
authors.lastname: Nakhjavani
mesh_terms: D000328:Adult; D062107:Advanced Oxidation Protein Products / Q000097:blood; D000975:Antioxidants / Q000032:analysis*; D043303:Aryldialkylphosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy* / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D017127:Glycation End Products, Advanced / Q000097:blood; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D007328:Insulin / Q000097:blood; D054709:Lecithins / Q000097:blood; D008019:Life Style; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects*; D007862:Phosphatidylcholine-Sterol O-Acyltransferase / Q000097:blood
chemical_list: D062107:Advanced Oxidation Protein Products; D000975:Antioxidants; D043303:Aryldialkylphosphatase; D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D007004:Hypoglycemic Agents; D007328:Insulin; D054709:Lecithins; D008687:Metformin; D007862:Phosphatidylcholine-Sterol O-Acyltransferase