Differential effects of metformin on age related comorbidities in older men with type 2 diabetes

Wang, Chen Pin; Lorenzo, Carlos; Habib, Samy L.; Jo, Booil; Espinoza, Sara

doi:10.1016/j.jdiacomp.2017.01.013

Cited by 110 publications

(88 citation statements)

References 47 publications

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“…Of note, the scores on the perception of general health and role limitations due to physical health did not improve among the women treated with metformin; better scores at follow-up were achieved by the women in the lifestyle modifications only group. Several studies have documented a beneficial impact of metformin on diabetes-related depression clinically, 33,35,53 and experimentally, 36,54 although in some cases, the antidepressant effect was not reported. 27,55 Metformin has also demonstrated an anti-anxiety effect among patients with diabetes 56 as well as in animal models.…”

Section: Discussionmentioning

confidence: 99%

<p>Metformin Improves the Depression Symptoms of Women with Polycystic Ovary Syndrome in a Lifestyle Modification Program</p>

Alhussain¹,

AlRuthia²,

Al‐Mandeel³

et al. 2020

PPA

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Background: Metformin is commonly prescribed to manage polycystic ovary syndrome (PCOS), which is one of the most common endocrine disorders among women of childbearing age and is associated with high prevalence rates of depression and anxiety.Objective: This study's objective was to determine the impact of prescribed metformin on depression and anxiety levels of patients with PCOS. Methods: This prospective, multi-center, cohort study examined the impact of prescribed metformin on the depression and anxiety of women with PCOS in four gynecology clinics in Saudi Arabia and Jordan. The women had recently been prescribed metformin along with lifestyle modifications, such as diet and exercise, and were compared to another group of women with PCOS who were prescribed lifestyle modifications only. Depression and anxiety were assessed at baseline and three months later using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) scale, respectively. Health-related quality of life was measured using the Short Form Health Survey (SF-36). Multiple logistic regression analyses were conducted to examine the impact of metformin on depression and anxiety. Results: Eighty-six women participated in the study: 53 were prescribed metformin with lifestyle modifications, and 33 were prescribed lifestyle modifications only. The women on metformin had 70% lower odds of having major depression (PHQ-9≥10) (OR=0.302, P=0.045); however, no significant effect of metformin on anxiety (GAD-7≥10) was found. Conclusion: Metformin may have a role in the management of depression symptoms among patients with PCOS; however, its potential antidepressant effect should be further examined in randomized double-blind placebo-controlled clinical trials.

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Section: Discussionmentioning

confidence: 99%

<p>Metformin Improves the Depression Symptoms of Women with Polycystic Ovary Syndrome in a Lifestyle Modification Program</p>

Alhussain¹,

AlRuthia²,

Al‐Mandeel³

et al. 2020

PPA

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“…In a large, observational study conducted in US veterans with type 2 diabetes and stratified according to baseline risk, treatment with metformin reduced the risk of multiple age-related diseases, including CVDs, cancer, depression, and frailty-related diseases 254 . An RCT conducted in Indonesia revealed that metformin improves gait speed, but not handgrip strength, in nondiabetic, pre-frail, older individuals 255 .…”

Section: Inflammation and Age-related Frailtymentioning

confidence: 99%

Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty

2018

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Most older individuals develop inflammageing, a condition characterized by elevated levels of blood inflammatory markers that carries high susceptibility to chronic morbidity, disability, frailty, and premature death. Potential mechanisms of inflammageing include genetic susceptibility, central obesity, increased gut permeability, changes to microbiota composition, cellular senescence, NLRP3 inflammasome activation, oxidative stress caused by dysfunctional mitochondria, immune cell dysregulation, and chronic infections. Inflammageing is a risk factor for cardiovascular diseases (CVDs), and clinical trials suggest that this association is causal. Inflammageing is also a risk factor for chronic kidney disease, diabetes mellitus, cancer, depression, dementia, and sarcopenia, but whether modulating inflammation beneficially affects the clinical course of non-CVD health problems is controversial. This uncertainty is an important issue to address because older patients with CVD are often affected by multimorbidity and frailty — which affect clinical manifestations, prognosis, and response to treatment — and are associated with inflammation by mechanisms similar to those in CVD. The hypothesis that inflammation affects CVD, multimorbidity, and frailty by inhibiting growth factors, increasing catabolism, and interfering with homeostatic signalling is supported by mechanistic studies but requires confirmation in humans. Whether early modulation of inflammageing prevents or delays the onset of cardiovascular frailty should be tested in clinical trials.

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“…A recent cohort study of US older veterans with type 2 diabetes showed that metformin reduced CVD events among individuals with type 2 diabetes, according to the baseline risk [39]. The likelihood of CVD was reduced by 6 % among otherwise healthy individuals, by 18 % among those at risk of frailty and by 48 % among those at high cardiovascular risk.…”

Section: Clinical Impact Of Metformin Beyond Glycaemic Controlmentioning

confidence: 99%

“…It is yet to be established whether metformin enhances physical function and mobility, or prevents their decline in older adults. However, in an observational study metformin seemed to decrease the likelihood of frailty and other age-related comorbidities [39]. …”

Section: Clinical Impact Of Metformin Beyond Glycaemic Controlmentioning

confidence: 99%

Metformin and ageing: improving ageing outcomes beyond glycaemic control

et al. 2017

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In a world where the population is ageing, there is growing interest and demand for research evaluating strategies that address the ageing process. After 60 years of successful use of metformin in our pharmaceutical armamentarium, we are learning that, beyond improving glycaemic control, metformin may have additional mechanisms and pathways of action that need further study. Although, metformin’s effect on clinical ageing outcomes may still be considered speculative, the findings from studies into cellular and animal models and from observational and pilot human studies support the existence of beneficial effects on ageing. At present, progress for human research, using randomised clinical trials to evaluate metformin’s clinical impact, has just started. Here, we present a review on the ageing process and the mechanisms involved, and the role that metformin may have to counter these. We go on to discuss the upcoming large randomised clinical trials that may provide insight on the use of metformin for ageing outcomes beyond glycaemic control.

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Differential effects of metformin on age related comorbidities in older men with type 2 diabetes

Cited by 110 publications

References 47 publications

<p>Metformin Improves the Depression Symptoms of Women with Polycystic Ovary Syndrome in a Lifestyle Modification Program</p>

<p>Metformin Improves the Depression Symptoms of Women with Polycystic Ovary Syndrome in a Lifestyle Modification Program</p>

Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty

Metformin and ageing: improving ageing outcomes beyond glycaemic control

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