Short-Term Treatment with Metformin Improves the Cardiovascular Risk Profile in First-Degree Relatives of Subjects with Type 2 Diabetes Mellitus who have a Metabolic Syndrome and Normal Glucose Tolerance without Changes in C-Reactive Protein or Fibrinogen

Abstract

de Lima LMA, Wiernsperger N, Kraemer-Aguiar LG, Bouskela L. Short-term treatment with metformin improves the cardiovascular risk profile in first-degree relatives of subjects with type 2 diabetes mellitus who have a metabolic syndrome and normal glucose tolerance without changes in C-reactive protein or fibrinogen. Clinics. 2009;64(5):415-20. OBJECTIVE:To study if metformin, when administered to first-degree relatives of type 2 diabetes mellitus subjects who have metabolic syndrome and normal glucose tolerance, could improve the cardiovascular risk profile and reduce the levels of both C-reactive protein and fibrinogen. INTRODUCTION: Metabolic syndrome is associated with higher cardiovascular morbidity and mortality. Metformin has vasculoprotective effects even in normoglycemic subjects, and C-reactive protein and fibrinogen are considered markers of endothelial injury and inflammation. METHODS: Thirty-one non-diabetic first-degree relatives of type 2 diabetes mellitus subjects with metabolic syndrome were randomized (1:1) and double-blinded for placement in the placebo and metformin groups (850mg bid/±90days); 16 subjects were administered metformin (mean age 40.0 [33.5-50] years; 13 females) and 15 subjects were in the placebo group (mean age 37.0 [32-42] years; 9 females). Blood samples were collected at baseline and at the end of treatment for biochemical analyses, including an assessment of C-reactive protein and fibrinogen levels. RESULTS: Metformin improved the lipid profile and decreased fasting plasma glucose, systolic blood pressure, weight and body mass index without changing body composition. For those in the placebo we identified no changes in fibrinogen (282.2 [220.4-323.7] mg/L vs. 286.7 [249.6-295.1] mg/L; NS) or in C-reactive protein levels (0.68 [0.3-1.2] vs. 0.64 [0.3-1.0] mg/L; NS). The same was also observed for the levels of fibrinogen (303.9 [217.6-347.6] mg/L vs. 290.9 [251.5-301.9] mg/L; NS) and C-reactive proteins (0.78 [0.3-1.1] vs. 0.80 [0.4-0.9] mg/L; NS) in the metformin group. CONCLUSIONS: Metformin treatment in first-degree relatives of type 2 diabetes mellitus sufferers who have metabolic syndrome and normal glucose tolerance improved the cardiovascular risk profile without changing the levels of C-reactive protein and fibrinogen.

Metformin improves in vivo and in vitro B cell function in individuals with obesity and Type-2 Diabetes

“…For example, it has been shown that MET reduces lipopolysaccharide-induced proinflammatory responses in monocyes and macrophages [2], down-regulates Th17 cells in Rheumatoid Arthritis patients [3], decreases TNF-α receptor signaling and NF-kB activation in endothelial cells [4,5] and smooth muscle cells [6], and inhibits intestinal inflammation and colitis-associated colon cancer in intestinal epithelial cells [7]. MET has also been suggested to have cardioprotective effects through its reduction of inflammation, improvement of lipid profiles [8] and endothelial cell function [9], and retardation of the process of coronary artery calcification [10]. …”

Statin use and risk of diabetes mellitus

“…В ходе основного ис-следования наблюдалось значительное снижение риска развития СД у пациентов, получавших сочетанную те-рапию амлодипином и периндоприлом, по сравнению с группой, получавшей терапию атенолол+тиазидный диуретик. Для предотвращения одного впервые выявлен-ного случая СД необходимо было пролечить 30 пациентов в течение 5 лет (95%, интервал доверия [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. Среди пациентов, включенных в исследование, 10,305 больных с уровнем общего холестерола 6,5 ммоль/л и ниже были в дальнейшем рандомизированы на две группы: группа аторвастатина (10 мг/сут) и контрольная группа (ASCOT-2/2012 Дискуссия Сахарный диабет.…”

“…На фоне терапии метформином отмечается достоверное улучшение липидного профиля, снижение систоличес-кого АД, веса, ИМТ и снижение риска развития ССО в целом [25]. В исследовании UKPDS (United Kingdom.…”

Distúrbios metabólicos em doenças infecciosas emergentes e negligenciadas

“…A metformina (MTF) promove melhor controle glicêmico e redução de risco cardiovascular no cenário de resistência à insulina e é considerada a terapia farmacológica de escolha. Em pacientes intolerantes à glicose e mesmo nos normoglicê-micos, a MTF tem mostrado um papel benéfico sobre o perfil metabólico e a função endotelial (20). Entretanto, alguns estudos têm apontado que essa droga pode acentuar a perda de gordura subcutânea, tornando a lipoatrofia mais evidente (13 Os fibratos são as drogas de escolha quando os níveis de triglicerídeos excedem 500 mg/dl.…”