Background

Cardiovascular (CV) disease is the leading cause of death worldwide. Early assessment of CV disease in at-risk patients is important for the development or modification of therapeutic strategies and patient’s lifestyles. Current known diagnosis methods heavily rely on clinical history and physical examination by a physician. However CV diseases, especially in early stages, generally cause non-specific symptoms that can be easily missed.

Metformin is currently the most widely used glucose-lowering agent in the world. It has been used since 1957 to treat type 2 diabetes however, no reliable biomarker for metformin’s presence or dose has been identified thus far. This limits the ability to assess the effects of metformin in people with normal glucose homeostasis. Furthermore, at present, it