Methylglyoxal (MG) is a highly reactive dicarbonyl compound involved in
the formation of advanced glycation endproducts (AGE). Levels of MG are elevated
in patients with type-2 diabetes mellitus (T2DM), and AGE have been implicated
in the progression of diabetic complications. The antihyperglycemic drug
metformin (MF) has been suggested to be a scavenger of MG. The present work
examined and characterized unequivocally the resulting scavenged product from
the metformin–MG reaction. The primary product was characterized by
1H, 13C, 2D-HSQC, and HMBC NMR and tandem mass
spectrometry. X-ray diffraction analysis determined the structure of the
metformin and MG-derived imidazolinone compound as
(E)-1,1-dimethyl-2-(5-methyl-4-oxo-4,5-dihydro-1H-imidazol-2-yI)guanidine
(IMZ). A LC-MS/MS multiple reaction monitoring method was developed to detect
and quantify the presence of IMZ in metformin-treated T2DM patients. Urine from
>90 MF-treated T2DM patients was analyzed, with increased levels of MF
directly correlating with elevations in IMZ. Urinary MF was detected in the
range of 0.17 μM to 23.0 mM, and simultaneous
measurement of IMZ concentrations were in the range of 18.8 nM to 4.3
μM. Since plasma concentrations of MG range from 40
nM to 4.5 μM, the level of IMZ production may be of
therapeutic significance. Thus, in addition to lowering hepatic gluconeogenesis,
metformin also scavenges the highly reactive MG in vivo,
thereby reducing potentially detrimental MG protein adducts, with subsequent
reductions in diabetic complications.