High Accumulation of Metformin in Colonic Tissue of Subjects With Diabetes or the Metabolic Syndrome
Abstract
72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 Dear Editors: The recognition that the hyperinsulinemic state is associated with the metabolic syndrome or type II diabetes mellitus is linked with increased colorectal cancer risk has led to studies of antidiabetes drugs to prevent cancer. Metformin has multiple actions that contribute to its potential anticancer effects, and has been associated with reduced cancer incidence and mortality in diabetic patients and patients with colorectal cancer specifically. In a recent double-blind, placebo-controlled, randomized phase III clinical trial in 151 patients, a low dose of 250 mg/d of metformin was associated with a decrease of approximately 40% in colorectal adenoma recurrence 1 year after initial polypectomy. Although the liver is recognized as the major site of metformin pharmacodynamics, the gut as an important site of action. To date, confirmation that metformin can reach the colonic tissue and attain adequate levels to exert direct potential antitumor effects in humans is lacking. We performed a pilot study in 12 subjects with diabetes or the metabolic syndrome to compare metformin concentrations in plasma with colonic tissue according to colon site. The median metformin plasma concentration was
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 151 participants or records.
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