<p>Effects of acarbose and metformin on the inflammatory state in newly diagnosed type 2 diabetes patients: a one-year randomized clinical study</p>

Abstract

Objective This study aimed to investigate the changes in inflammatory biomarkers between newly diagnosed type 2 diabetes (T2DM) patients under one-year acarbose treatments and those under metformin managements. Methods Seventy patients with newly diagnosed T2DM and 32 volunteers with normal glucose tolerance (normal controls, NCs) were enrolled. Seventy patients with T2DM were randomly assigned to two subgroups and treated with acarbose (n=34) or metformin (n=36) for 1 year. Blood glucose, insulin, glycosylated hemoglobin (A1C), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and inflammatory biomarker levels (interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-2 (IL-2), and ferritin) were detected at 0, 6 and 12 months. Results After adjusting for sex, the waist-to-hip ratio (WHR) and body mass index (BMI), higher fasting plasma glucose (FPG), standard meal test 1/2 hr and 2 hr glucose, TG, TC, LDL-C, IL-6, TNF-α, IL-2 and ferritin levels were observed in T2DM group than in NCs ( P <0.05). After 6 months of treatment, TNF-α levels were significantly decreased in both subgroups, and IL-6 and ferritin levels were significantly decreased after 12 months ( P <0.05). However, no significant differences in the IL-6, TNF-α and ferritin levels were observed between the two subgroups. Moreover, significantly higher IL-6 and TNF-α levels were detected in the T2DM group than in NCs after 12 months of treatment ( P <0.05). Conclusion Patients with newly diagnosed T2DM exhibited a marked chronic inflammatory state characterized by increased IL-6, TNF-α, IL-1β, IL-2 and ferritin levels. After 1 year of treatment with acarbose or metformin, IL-6, TNF-α, IL-1β and ferritin levels were significantly decreased compared with the baseline. The anti-inflammatory effects of acarbose and metformin were comparable and required a long-term treatment (1 year), but the characteristics were different. Further investigations are needed to determine whether this effect was independent of the hypoglycemic effects.

Anti-inflammatory properties of antidiabetic drugs: A “promised land” in the COVID-19 era?

“…significantly lowered IL-6 (from 133 ± 68 to 114 ± 57 pg/mL, p < 0.05) at 12 months in 36 T2DM patients. 29 In the same study, ferritin was also decreased (from 171 ± 23 to 164 ± 19 ng/mL, p < 0.05) following metformin treatment. 29 …”

Effect of Metformin on Circulating Levels of Inflammatory Markers in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials

“…Sensitivity analysis indicated that the removal of 2 studies (Gamit et al 34 and Mo et al 26 ) with low quality by means of "leave-one-out method" from the analysis of CRP ([SMD = −0.78 mg/L; 95% CI = −1.53, −0.027; P = 0.04), TNF-α (SMD = 0.09 mg/L; 95% CI = −0.52, 0.71; P = 0.77), and IL-6 (SMD = 0.18 mg/L; 95% CI = −0.52, 0.90; P = 0.60) did not change the results of the current pooled analysis for circulating levels of CRP, TNF-α, and IL-6 (Figure 3). Forest plot evaluating standardized mean difference (SMD) and 95% CIs for the impact of metformin treatment on circulating levels of (A) C-reactive protein, (B) tumor necrosis factor-α, and (C) interleukin-6 in patients with T2D.…”

Prognostic roles of diabetes mellitus and hypertension in advanced hepatocellular carcinoma treated with sorafenib

“…https://doi.org/10.1371/journal.pone.0244293.g002 Abbreviation: VEGF, vascular endothelial growth factor; VEGFR, VEGF receptor; PDGF, platelet-derived growth factor; PDGFR, PDGF receptor; PKC, protein kinase C; IGF-1, insulin-like growth factor 1; IGF-1R, IGF-1 receptor; PI3K, phosphoinositide 3-kinase; LKB1, liver kinase B1; AMPK, adenosine 5'-monophosphate-activated protein kinase; TSC1/2, tuberous sclerosis proteins 1 and 2 complex; mTOR, mammalian Target of Rapamycin. levels of tumor necrosis factor (TNF)-α and IL-6, including glimepiride, repaglinide [44], acarbose [45][46][47], glibenclamide [48], gliclazide [49], linagliptin [50,51] and saxagliptin [52][53][54]. TNF-α, a pro-inflammatory cytokine, significantly over-expresses in HCC patients and favors inflammation leading to poorer prognosis in sorafenib-treated HCC [55,56].…”