The Effect of Metformin and Intensive Lifestyle Intervention on the Metabolic Syndrome: The Diabetes Prevention Program Randomized Trial

Orchard, Trevor J.; Temprosa, Marinella; Gol'dberg, R. S.

doi:10.1016/j.accreview.2005.06.031

Cited by 107 publications

(157 citation statements)

References 15 publications

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“…Approximately 50% of individuals with IGT have metabolic syndrome (3). Lifestyle modification or metformin decrease metabolic syndrome prevalence (3), and the combined treatment may have additive effects (18). In this study, we showed that structured exercise training and/or metformin had similar effects on reducing metabolic syndrome severity (i.e., Z‐score; Figure 2a).…”

Section: Discussionmentioning

confidence: 99%

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Metformin modifies the exercise training effects on risk factors for cardiovascular disease in impaired glucose tolerant adults

Malin

Nightingale

Choi

et al. 2013

Obesity

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Impaired glucose tolerant (IGT) adults are at elevated risk for cardiovascular disease (CVD). Exercise or metformin reduce CVD risk, but the efficacy of combining treatments is unclear. To determine the effects of exercise training plus metformin, compared to each treatment alone, on CVD risk factors in IGT adults. Subjects were assigned to: placebo (P), metformin (M), exercise plus placebo (EP), or exercise plus metformin (EM) (8/group). In a double-blind design, P or 2000mg/d of M were administered for 12 weeks and half performed aerobic and resistance training 3 days/week for approximately 60 minutes/day at 70% pre-training heart rate peak. Outcomes included: adiposity, blood pressure (BP), lipids and high sensitivity C-reactive protein (hs-CRP). Z-scores were calculated to determine metabolic syndrome severity. M and EM, but not EP, decreased body weight compared to P (p <0.05). M and EP lowered systolic BP by 6% (p < 0.05), diastolic BP by 6% (p < 0.05), and hs-CRP by 20% (M: trend p = 0.06; EP: p < 0.05) compared to P. Treatments raised HDL-cholesterol (p < 0.05; EM: trend p = 0.06) compared to P and lowered triacyglycerol (p < 0.05) and metabolic syndrome Z-score compared to baseline (EP; trend p = 0.07 and EM or M; p < 0.05). Although exercise and/or metformin improve some CVD risk factors, only training or metformin alone lowered hs-CRP and BP. Thus, metformin may attenuate the effects of training on some CVD risk factors and metabolic syndrome severity in IGT adults.

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Section: Discussionmentioning

confidence: 99%

“…1,2) and approximately half of these individuals have metabolic syndrome (i.e., hypertensive, hyperglycemic, and dyslipidemic; ref. 3). CVD risk is largely explained by insulin resistance and excess body weight (4,5).…”

Section: Introductionmentioning

confidence: 99%

Metformin modifies the exercise training effects on risk factors for cardiovascular disease in impaired glucose tolerant adults

Malin

Nightingale

Choi

et al. 2013

Obesity

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“…The biguanides (metformin) and the thiazolidinediones (TZDs) are 2 classes of drugs that target insulin resistance. Metfomin has been shown to reduce the incidence of MS by 17% compared with placebo in patients without MS at baseline 53 . It has also been shown to improve endothelial function in patients with MS 54 .…”

Section: Management Of Ms In East Asiansmentioning

confidence: 99%

The Metabolic Syndrome in East Asians

Hoang

Wong

2007

J Cardiometabolic Synd

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The metabolic syndrome is an emerging epidemic in developing nations, including East Asian countries such as China, Japan, and Korea. Studies examining the metabolic syndrome have used different definitions, with prevalence often highly dependent on the cut points for abdominal obesity utilized, which have been recommended by the International Diabetes Federation to be lower than standards used in Caucasians and other ethnic groups. Prevalence rates have generally varied from 8% to 13% in men and 2% to 18% in women, depending on ethnic group and definition used, and are consistently lower than most Western Caucasian populations. While recent dramatic changes in lifestyle from Westernization of dietary habits and reduced physical activity present challenges, an emphasis on healthful lifestyle changes remains the cornerstone for metabolic syndrome management. In addition, clinical management focusing on control of obesity, elevated blood pressure, dyslipidemia, and hyperglycemia, with consideration of pharmacologic therapy issues unique to certain Asian populations, remains important for reducing associated cardiometabolic risks.

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“…The totality of evidence supporting screening for hyperglycemia is strong (Table 1) and should persuade the USPSTF to adopt its new set of recommendations for type 2 diabetes and prediabetes screening. IGT and/or IFG to type 2 diabetes (23) Evidence of benefit for early treatment of hyperglycemia c Reduction in incidence of CVD and mortality (4) c Reduction in the incidence of retinopathy (9) c Reduction in incidence of diabetes among people with IGT (24) c Regression of prediabetes to normoglycemia (10) c Reduction in cardiometabolic risk factors (11) c Reduction in the development of metabolic syndrome (12) c Reduction in the prevalence of urinary incontinence in women (13) c Improvement in quality of life (14) c Evidence for cost-effectiveness of early detection and treatment (16-19) c Limited psychological impact on participants (20) …”

mentioning

confidence: 99%

“…Furthermore, although not addressed by Herman et al, prediabetes and type 2 diabetes are part of a continuum, needing the same screening and diagnostic tests and requiring the same initial treatment (i.e., lifestyle intervention or metformin) (1), and a large body of evidence now exists that identifying people with prediabetes (impaired glucose tolerance [IGT] and/or impaired fasting glucose [IFG]) and delivering lifestyle, drug, or multicomponent intervention can considerably lower the risk of type 2 diabetes (8) and related complications (9)(10)(11)(12)(13)(14). Thus, screening would help promote the implementation of effective prevention for those at high risk for type 2 diabetes (15).…”

mentioning

confidence: 99%