title: Effects of metformin on blood and urine pro-inflammatory mediators in patients with type 2 diabetes.
abstract: BACKGROUND
  Metformin 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.
  
  
  RESULTS
  We 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.
  
  
  CONCLUSIONS
  Metformin reduces inflammatory responses without influence on renal function in type 2 diabetic patients.
authors.affiliation: School of Medicine, Shandong University, Jinan, Shandong China ; Department of Nephrology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, Anhui China.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Cadre Wards, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, Anhui China.
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Endocrinology, Affiliated Anhui Provincial Hospital, Anhui Medical University, Hefei, Anhui 230001 People's Republic of China.
authors.forename: Shandong
authors.initials: S
authors.lastname: Ye
keywords: Diabetes; Hypertension; Inflammatory responses; Metformin; Renal function