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Does metformin increase the serum total homocysteine level in non‐insulin‐dependent diabetes mellitus?
Author(s) -
Hoogeveen E. K.,
Kostense P. J.,
Jakobs C.,
Bouter L. M.,
Heine R. J.,
Stehouwer C. D. A.
Publication year - 1997
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1046/j.1365-2796.1997.00231.x
Subject(s) - medicine , metformin , homocysteine , diabetes mellitus , endocrinology , confidence interval , creatinine , insulin , risk factor
Hoogeveen EK, Kostense PJ, Jakobs C, Bouter LM, Heine RJ, Stehouwer CDA (Vrije Universiteit, Amsterdam, the Netherlands). Does metformin increase the serum total homocysteine level in non‐insulin‐dependent diabetes mellitus? J Intern Med 1997; 242 : 389–94. Objective The aim of this study was to estimate the effect of metformin on the serum total homocysteine level in non‐insulin‐dependent diabetes mellitus (NIDDM) patients. An elevated serum total homocysteine level is a risk factor for atherosclerosis. Metformin decreases serum vitamin B 12 , and may thereby indirectly increase the serum total homocysteine level. Design A cross‐sectional study in a primary care setting. Subjects, main outcome measures Fasting serum total homocysteine level was measured in 40 NIDDM patients who had received treatment with metformin (500–2550 mg per day) for at least six months, and in 71 NIDDM patients not treated with metformin and matched for sex, age (± 5 years), serum creatinine (± 5 μmol L −1 ) and current smoking habits. ‘Exposed’ patients were matched with ‘nonexposed’ patients. A two‐way analysis of variance was performed. Results The mean serum total homocysteine level was 11.5 μmol L −1 in the metformin‐exposed patients and 10.6 μmol L −1 in the nonexposed patients. Thus, the metformin‐exposed patients had slightly higher serum total homocysteine levels (difference 0.8 μmol L −1 , 95% confidence interval (−0.4–2.0 μmol L −1 ). Results were similar in men and women. Finally, no dose–response relationship between cumulative exposure to metformin (dose × duration of treatment) and the serum total homocysteine level could be demonstrated. Conclusion We conclude that the effect of metformin on serum total homocysteine level in NIDDM patients, if any, is likely to be small.