Department of Endocrinology, University Hospital MAS, Malmö, Sweden.
Diabetes Care. 2010 Jun;33(6):1291-3. doi: 10.2337/dc09-1284. Epub 2010 Mar 9.
To study trough levels of metformin in serum and its intra-individual variation in patients using a newly developed assay.
Trough serum levels of metformin were measured once using liquid chromatography-tandem mass spectrometry (LCMSMS) in 137 type 2 diabetic patients with varying renal function (99 men) and followed repeatedly during 2 months in 20 patients (16 men) with estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2) body surface.
Patients with eGFR >60, 30-60, and <30 ml/min/1.73 m(2) had median trough metformin concentrations of 4.5 micromol/l (range 0.1-20.7, n = 107), 7.71 micromol/l (0.12-15.15, n = 21), and 8.88 micromol/l (5.99-18.60, n = 9), respectively. The median intra-individual overall coefficient of variation was 29.4% (range 9.8-74.2).
Determination of serum metformin with the LCMSMS technique is useful in patients on metformin treatment. Few patients had values >20 micromol/l. Metformin measurement is less suitable for dose titration.
使用新开发的检测方法研究血清中二甲双胍的浓度及其个体内变异性。
对 137 例不同肾功能（99 名男性）的 2 型糖尿病患者单次使用液相色谱-串联质谱法（LCMSMS）检测血清二甲双胍的谷浓度，并对 20 例肾小球滤过率（eGFR）<60ml/min/1.73m(2)的患者进行了 2 个月的重复检测（16 名男性）。
eGFR>60、30-60 和<30ml/min/1.73m(2)的患者的血清二甲双胍谷浓度中位数分别为 4.5μmol/l（范围 0.1-20.7，n=107）、7.71μmol/l（0.12-15.15，n=21）和 8.88μmol/l（5.99-18.60，n=9）。个体内总体变异系数的中位数为 29.4%（范围 9.8-74.2）。
使用 LCMSMS 技术测定血清中的二甲双胍对于接受二甲双胍治疗的患者是有用的。少数患者的浓度值>20μmol/l。二甲双胍的测定不太适合剂量调整。
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