A comparative study of the glycemic control of various antidiabetic agents and the role of homocysteine in the therapy of type 2 diabetes mellitus

Yegnanarayan, Radha; Suryavanshi, Mahesh; Singh, Manmohan; Desai, Supriya

doi:10.1016/j.jdiacomp.2006.09.001

Cited by 13 publications

(6 citation statements)

References 31 publications

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“…Current research suggests that when cellular Hcy leaks into the circulation, even in slightly elevated amounts, the risk of coronary heart disease, stroke, peripheral vascular disease, and venous thrombosis and embolism increases significantly [20]. Our findings show that folate supplementation decreased the level of Hcy, which is in agreement with results of earlier studies; however, the percentage decrease differs [2,14,[21][22][23][24]. Differences in duration of therapy and dose of folic acid could account for these differences.…”

Section: Discussionsupporting

confidence: 91%

“…The placebo was similar to the folate tablets in appearance and taste. The folic acid dose was chosen by taking previous studies into account [2,15].…”

Section: Subjectsmentioning

confidence: 99%

“…Metformin does not promote weight gain or hypoglycemia; it is considered first-line therapy in type 2 diabetes mellitus patients [2]. However, it reduces levels of folate and vitamin B12, thereby increasing the Hcy level, probably due to malabsorption [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Folic Acid Supplementation on Homocysteine, Serum Total Antioxidant Capacity, and Malondialdehyde in Patients with Type 2 Diabetes Mellitus

Aghamohammadi

Gargari

Aliasgharzadeh

2011

Journal of the American College of Nutrition

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Section: Discussionsupporting

confidence: 91%

“…The placebo was similar to the folate tablets in appearance and taste. The folic acid dose was chosen by taking previous studies into account [2,15].…”

Section: Subjectsmentioning

confidence: 99%

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Effect of Folic Acid Supplementation on Homocysteine, Serum Total Antioxidant Capacity, and Malondialdehyde in Patients with Type 2 Diabetes Mellitus

Aghamohammadi

Gargari

Aliasgharzadeh

2011

Journal of the American College of Nutrition

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“…The increase of serum Hcy concentration in the metformin-treated patients was confirmed by a series of observational studies [16][17][18]20,25,[52][53][54][55][56]. These studies indicated that metformin was associated with an elevated concentration of serum Hcy compared with control treatment.…”

Section: Discussionmentioning

confidence: 79%

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhang

et al. 2016

Value in Health

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Abstract:The aim of this systematic review is to assess whether metformin could change the concentration of serum homocysteine (Hcy) with and without simultaneous supplementation of B-group vitamins or folic acid. A literature search was conducted in PubMed, EmBase, and Cochrane Central Register of Controlled Trials (CENTRAL) to identify randomized controlled trials (RCTs) reporting the concentration of serum Hcy in metformin-treated adults. Meta-analysis was applied to assess the association between metformin and the changes of Hcy concentration. Twelve publications were included in this study. In the overall analysis, metformin administration was not statistically associated with the change of Hcy when compared with the control treatment (mean difference (MD), 0.40 µmol/L; 95% confidence interval (CI), −0.07~0.87 µmol/L, p = 0.10). In the subgroup analysis, metformin was significantly associated with an increased concentration of Hcy in the absence of exogenous supplementation of folic acid or B-group vitamins (MD, 2.02 µmol/L; 95% CI, 1.37~2.67 µmol/L, p < 0.00001), but with a decreased concentration of serum Hcy in the presence of these exogenous supplementations (MD, −0.74 µmol/L; 95% CI, −1.19~−0.30 µmol/L, p = 0.001). Therefore, although the overall effect of metformin on the concentration of serum Hcy was neutral, our results suggested that metformin could increase the concentration of Hcy when exogenous B-group vitamins or folic acid supplementation was not given.

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“…However, metformin also reduced serum levels of folate and vitamin B12 and increased serum Hcy levels in patients with diabetes (13,14), even after only a short period (5). Long-term administration of metformin was shown to result in malabsorption of vitamin B12 (15), although the correlation between serum Hcy levels and absorption of folate or vitamin B12 was not clear.…”

Section: Discussionmentioning

confidence: 99%

Effects of Metformin With or Without Supplementation With Folate on Homocysteine Levels and Vascular Endothelium of Women With Polycystic Ovary Syndrome

et al. 2009

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OBJECTIVETo evaluate whether the administration of metformin exerts any effects on serum homocysteine (Hcy) levels in patients with polycystic ovary syndrome (PCOS) and whether supplementation with folate enhances the positive effects of metformin on the structure and function of the vascular endothelium.RESEARCH DESIGN AND METHODSA total of 50 patients affected by PCOS, without additional metabolic or cardiovascular diseases, were enrolled in a prospective nonrandomized placebo-controlled double-blind clinical study. They were grouped into two treatment arms that were matched for age and BMI. Patients were treated with a 6-month course of metformin (1,700 mg daily) plus folic acid (400 μg daily; experimental group, n = 25) or placebo (control group, n = 25). Complete hormonal and metabolic patterns, serum Hcy, folate, vitamin B12, endothelin-1 levels, brachial artery diameter at the baseline (BAD-B) and after reactive hyperemia (BAD-RH), flow-mediated dilation, and intima-media thickness in both common carotid arteries were evaluated.RESULTSAfter treatment, a significant increase in serum Hcy levels was observed in the control group compared with the baseline values and the experimental group. A beneficial effect was observed in the concentrations of BAD-B, BAD-RH, flow-mediated dilation, intima-media thickness, and serum endothelin-1 in both groups. However, the results were improved more significantly in the experimental group than in the control subjects.CONCLUSIONSMetformin exerts a slight but significant deleterious effect on serum Hcy levels in patients with PCOS, and supplementation with folate is useful to increase the beneficial effect of metformin on the vascular endothelium.

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A comparative study of the glycemic control of various antidiabetic agents and the role of homocysteine in the therapy of type 2 diabetes mellitus

Cited by 13 publications

References 31 publications

Effect of Folic Acid Supplementation on Homocysteine, Serum Total Antioxidant Capacity, and Malondialdehyde in Patients with Type 2 Diabetes Mellitus

Effect of Folic Acid Supplementation on Homocysteine, Serum Total Antioxidant Capacity, and Malondialdehyde in Patients with Type 2 Diabetes Mellitus

Metformin Treatment and Homocysteine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effects of Metformin With or Without Supplementation With Folate on Homocysteine Levels and Vascular Endothelium of Women With Polycystic Ovary Syndrome

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