Metformin Improves Diastolic Function in Non-diabetic Patients with Metabolic Syndrome

A study has revealed that the use of metformin, in addition to lifestyle counseling, seems to improve diastolic function in non-diabetic patients with metabolic syndrome or MetS.

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There was a total of 54 non-diabetic adults with MetS and diastolic dysfunction were randomized to undergo lifestyle counseling alone or with metformin with target dose of 1,000 mg twice a day. The primary result was diastolic function, evaluated as the change in mean e’ velocity which was measured at baseline, 6, 12, and 24 months. Secondary results included improvements in insulin resistance, functional capacity, and quality of life or QoL.

Among the patients, 49 were included in the modified intention-to-treat or mITT analysis with average age of 51.8 years old, where 55% were male. Metformin treatment produced a substantial decrease in Homeostatic Model Assessment for Insulin Resistance or HOMA-IR.

The linear mixed effects modeling revealed a significant between-group difference in diastolic function during the study period, in favor of the metformin arm. The average change in e’ velocity at 24 months was 0.67 cm/s in the metformin arm vs -0.33 cm/s in the control arm in the mITT population. Corresponding changes in the PP population were 0.80 vs -0.37 cm/s.

Lastly, the peak oxygen uptake and short form [SF]-36 scores were comparable in the two treatment arms.

The metformin is the most widely used oral glucose-lowering drug among patients with Type 2 diabetes. Several studies reporting that the drug has direct cardioprotective effects, improving diastolic function in the diabetic patients undergoing coronary angiography, reducing capillary wedge pressure and left ventricular end-diastolic pressure in dogs, and lowering left ventricular end-diastolic pressure in a nondiabetic rat model.

 

Source: Endocrine 2021;72:699-710

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