Effects of 1-year treatment with metformin on metabolic and cardiovascular risk factors in non-diabetic upper-body obese subjects with mild glucose anomalies: A post-hoc analysis of the BIGPRO1 trial

Abstract Aim Metformin has recently been considered as a possible pharmacological complement to lifestyle measures for preventing type 2 diabetes in high-risk subjects. However, little is known of its effects on metabolic and cardiovascular risk factors in non-diabetic subjects. Methods The BIGPRO1...

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Bibliographic Details
Published in:Diabetes & metabolism 2009-11, Vol.35 (5), p.385-391
Main Authors: Fontbonne, A, Diouf, I, Baccara-Dinet, M, Eschwege, E, Charles, M.-A
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Blood Glucose - analysis
Blood Pressure - drug effects
Cardiometabolic risk factors
Cardiovascular Diseases - complications
Cardiovascular Diseases - epidemiology
Cholesterol - blood
Cholesterol, LDL - blood
Clinical trial
Diabetes Mellitus, Type 2 - drug therapy
Diabetes Mellitus, Type 2 - prevention & control
Diabetes. Impaired glucose tolerance
Double-Blind Method
Endocrine pancreas. Apud cells (diseases)
Endocrinology & Metabolism
Endocrinopathies
Essai clinique
Etiopathogenesis. Screening. Investigations. Target tissue resistance
Facteurs de risque cardiométaboliques
Female
Glucose Intolerance - complications
Glucose Intolerance - drug therapy
Humans
Hypoglycemic Agents - adverse effects
Hypoglycemic Agents - therapeutic use
Internal Medicine
Male
Medical sciences
Metabolic diseases
Metabolic Syndrome - complications
Metabolic Syndrome - epidemiology
Metformin
Metformin - adverse effects
Metformin - therapeutic use
Metformine
Middle Aged
Obesity
Obesity, Abdominal - complications
Prediabetes
Prédiabète
Risk Factors
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Summary:Abstract Aim Metformin has recently been considered as a possible pharmacological complement to lifestyle measures for preventing type 2 diabetes in high-risk subjects. However, little is known of its effects on metabolic and cardiovascular risk factors in non-diabetic subjects. Methods The BIGPRO1 trial was a 1-year multicentre, randomized, double-blind, controlled clinical trial of metformin versus placebo, carried out in the early 1990s, in 457 upper-body obese non-diabetic subjects with no cardiovascular diseases or contraindications to metformin. We compared the changes (1-year minus baseline) in cardiometabolic risk factors between treatment groups in two subsets of trial subjects: those with impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) ( n = 101); and those who fulfilled the inclusion criteria of the Diabetes Prevention Program (DPP) ( n = 51). Comparisons were adjusted for age and gender. Results In the IFG/IGT subset, significant differences in 1-year changes were observed for systolic blood pressure, which decreased markedly more in the metformin group than in the placebo group ( P < 0.003), and for fasting plasma glucose, and total and LDL cholesterol, which decreased slightly in the metformin group, but increased in the placebo group ( P < 0.04). Similar results were observed in the subset with DPP criteria. Also, there were no significant differences in 1-year changes for weight, waist-to-hip ratio, 2-h post-load blood glucose, fasting and 2-h post-load insulin, HDL cholesterol, triglycerides and fibrinolytic markers between the two treatment groups. Conclusion In subjects at high risk of developing diabetes, the use of metformin showed beneficial and no untoward effects on cardiometabolic risk factors.
ISSN:1262-3636
1878-1780
DOI:10.1016/j.diabet.2009.03.005