Blood pressure and cardiac autonomic nervous system in obese type 2 diabetic patients: effect of metformin administration
Hyperinsulinemia/insulin resistance and elevated plasma free fatty acids (FFA) levels are involved in the hypertension and cardiac sympathetic overactivity. Metformin improves insulin action and lower plasma FFA concentrations. We investigate the possible effect of metformin on arterial blood pressu...
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| Veröffentlicht in: | American journal of hypertension 2004-03, Vol.17 (3), p.223-227 |
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| creator | Manzella, Daniela Grella, Rodolfo Esposito, Katherine Giugliano, Dario Barbagallo, Mario Paolisso, Giuseppe |
| description | Hyperinsulinemia/insulin resistance and elevated plasma free fatty acids (FFA) levels are involved in the hypertension and cardiac sympathetic overactivity. Metformin improves insulin action and lower plasma FFA concentrations. We investigate the possible effect of metformin on arterial blood pressure (BP) and cardiac sympathetic nervous system.
One hundred twenty overweight type 2 diabetic patients were treated by placebo (
n = 60) + diet or metformin (850 mg twice daily) (
n = 60) + diet for 4 months, to evaluate the effect of metformin treatment on the cardiac autonomic nervous system. Insulin resistance was measured by the Homeostasis Model Assessment (HOMA) index. Heart rate variability (HRV) assessed cardiac sympathovagal balance.
Metformin treatment, but not placebo treatment, was associated with a decrease in fasting plasma glucose (
P < .05), insulin (
P < .05), triglyceride (
P < .05), and FFA (
P < .03) concentrations and HOMA index (
P < .03). Metformin treatment was also associated with a significant improvement in cardiac sympathovagal balance but not in mean arterial BP. Furthermore, in a multivariate analysis, delta change in sympathovagal balance index (LF/HF ratio) were associated with delta change in plasma FFA concentrations and HOMA index independently of gender and delta change in plasma triglyceride and HbA1c concentrations.
Our study demonstrated that metformin treatment might be useful for improving cardiac sympathovagal balance in obese type 2 diabetic patients. |
| doi_str_mv | 10.1016/j.amjhyper.2003.11.006 |
| format | Article |
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One hundred twenty overweight type 2 diabetic patients were treated by placebo (
n = 60) + diet or metformin (850 mg twice daily) (
n = 60) + diet for 4 months, to evaluate the effect of metformin treatment on the cardiac autonomic nervous system. Insulin resistance was measured by the Homeostasis Model Assessment (HOMA) index. Heart rate variability (HRV) assessed cardiac sympathovagal balance.
Metformin treatment, but not placebo treatment, was associated with a decrease in fasting plasma glucose (
P < .05), insulin (
P < .05), triglyceride (
P < .05), and FFA (
P < .03) concentrations and HOMA index (
P < .03). Metformin treatment was also associated with a significant improvement in cardiac sympathovagal balance but not in mean arterial BP. Furthermore, in a multivariate analysis, delta change in sympathovagal balance index (LF/HF ratio) were associated with delta change in plasma FFA concentrations and HOMA index independently of gender and delta change in plasma triglyceride and HbA1c concentrations.
Our study demonstrated that metformin treatment might be useful for improving cardiac sympathovagal balance in obese type 2 diabetic patients.</description><identifier>ISSN: 0895-7061</identifier><identifier>EISSN: 1879-1905</identifier><identifier>EISSN: 1941-7225</identifier><identifier>DOI: 10.1016/j.amjhyper.2003.11.006</identifier><identifier>PMID: 15001195</identifier><identifier>CODEN: AJHYE6</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Anthropometry ; Arterial hypertension. Arterial hypotension ; Autonomic Nervous System - drug effects ; Autonomic Nervous System - physiology ; Biological and medical sciences ; Biomarkers - blood ; Blood and lymphatic vessels ; Blood Glucose - drug effects ; Blood Glucose - metabolism ; blood pressure ; Blood Pressure - drug effects ; Blood Pressure - physiology ; Cardiology. Vascular system ; Diabetes Mellitus - drug therapy ; Diabetes Mellitus - physiopathology ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - physiopathology ; Fatty Acids, Nonesterified - blood ; Female ; free fatty acids ; Glycated Hemoglobin A - drug effects ; Glycated Hemoglobin A - metabolism ; Heart Rate - drug effects ; Heart Rate - physiology ; heart rate variability ; Humans ; Hypoglycemic Agents - therapeutic use ; insulin resistance ; Male ; Medical sciences ; Metformin ; Metformin - therapeutic use ; Middle Aged ; Multivariate Analysis ; Obesity ; Treatment Outcome ; Triglycerides - blood</subject><ispartof>American journal of hypertension, 2004-03, Vol.17 (3), p.223-227</ispartof><rights>2004 American Journal of Hypertension, Ltd.</rights><rights>2004 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Mar 2004</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c574t-f8036cae48400baa15d0b5020e59037b0265554cc158d82d47e5796f1ddc64e93</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15619779$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15001195$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manzella, Daniela</creatorcontrib><creatorcontrib>Grella, Rodolfo</creatorcontrib><creatorcontrib>Esposito, Katherine</creatorcontrib><creatorcontrib>Giugliano, Dario</creatorcontrib><creatorcontrib>Barbagallo, Mario</creatorcontrib><creatorcontrib>Paolisso, Giuseppe</creatorcontrib><title>Blood pressure and cardiac autonomic nervous system in obese type 2 diabetic patients: effect of metformin administration</title><title>American journal of hypertension</title><addtitle>AJH</addtitle><description>Hyperinsulinemia/insulin resistance and elevated plasma free fatty acids (FFA) levels are involved in the hypertension and cardiac sympathetic overactivity. Metformin improves insulin action and lower plasma FFA concentrations. We investigate the possible effect of metformin on arterial blood pressure (BP) and cardiac sympathetic nervous system.
One hundred twenty overweight type 2 diabetic patients were treated by placebo (
n = 60) + diet or metformin (850 mg twice daily) (
n = 60) + diet for 4 months, to evaluate the effect of metformin treatment on the cardiac autonomic nervous system. Insulin resistance was measured by the Homeostasis Model Assessment (HOMA) index. Heart rate variability (HRV) assessed cardiac sympathovagal balance.
Metformin treatment, but not placebo treatment, was associated with a decrease in fasting plasma glucose (
P < .05), insulin (
P < .05), triglyceride (
P < .05), and FFA (
P < .03) concentrations and HOMA index (
P < .03). Metformin treatment was also associated with a significant improvement in cardiac sympathovagal balance but not in mean arterial BP. Furthermore, in a multivariate analysis, delta change in sympathovagal balance index (LF/HF ratio) were associated with delta change in plasma FFA concentrations and HOMA index independently of gender and delta change in plasma triglyceride and HbA1c concentrations.
Our study demonstrated that metformin treatment might be useful for improving cardiac sympathovagal balance in obese type 2 diabetic patients.</description><subject>Aged</subject><subject>Anthropometry</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Autonomic Nervous System - drug effects</subject><subject>Autonomic Nervous System - physiology</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Blood and lymphatic vessels</subject><subject>Blood Glucose - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>blood pressure</subject><subject>Blood Pressure - drug effects</subject><subject>Blood Pressure - physiology</subject><subject>Cardiology. Vascular system</subject><subject>Diabetes Mellitus - drug therapy</subject><subject>Diabetes Mellitus - physiopathology</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Fatty Acids, Nonesterified - blood</subject><subject>Female</subject><subject>free fatty acids</subject><subject>Glycated Hemoglobin A - drug effects</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Heart Rate - drug effects</subject><subject>Heart Rate - physiology</subject><subject>heart rate variability</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>insulin resistance</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metformin</subject><subject>Metformin - therapeutic use</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Obesity</subject><subject>Treatment Outcome</subject><subject>Triglycerides - blood</subject><issn>0895-7061</issn><issn>1879-1905</issn><issn>1941-7225</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkU1v1DAQhiMEokvhL1SWENyyzGxiO-FEqYCCKoEEqKgXy7EnwmETB9up2H-PV7t8iAsX--Bnxu_MUxRnCGsEFM-GtR6Hr7uZwnoDUK0R1wDiTrHCRrYltsDvFitoWl5KEHhSPIhxAIBaCLxfnCAHQGz5qti93Hpv2RwoxiUQ05NlRgfrtGF6SX7yozNsonDrl8jiLiYamZuY7ygSSzkA27BMd5QyN-vkaErxOaO-J5OY79lIqfdhzDXa5tPFFDLlp4fFvV5vIz063qfF59evPl1cllfv37y9OL8qDZd1KvsGKmE01U0N0GmN3ELHYQPEW6hkBxvBOa-NQd7YZmNrSVy2okdrjaiprU6Lp4e-c_DfF4pJjS4a2m71RHkmJVHmhdYig4__AQe_hClnU7j_pW4l1pkSB8oEH2OgXs3BjTrsMqT2atSgfqlRezUKUWU1ufDs2H7pRrJ_yo4uMvDkCOho9LYPejIu_sUJbKXcD1QeuLxK-vH7XYdvSshKcnX55UZdVzfth4_vrhVm_sWBp7zlW5djRZMtGbIuZEfKeve_7D8BNezALw</recordid><startdate>20040301</startdate><enddate>20040301</enddate><creator>Manzella, Daniela</creator><creator>Grella, Rodolfo</creator><creator>Esposito, Katherine</creator><creator>Giugliano, Dario</creator><creator>Barbagallo, Mario</creator><creator>Paolisso, Giuseppe</creator><general>Elsevier Inc</general><general>Oxford University Press</general><general>Elsevier Science</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20040301</creationdate><title>Blood pressure and cardiac autonomic nervous system in obese type 2 diabetic patients: effect of metformin administration</title><author>Manzella, Daniela ; Grella, Rodolfo ; Esposito, Katherine ; Giugliano, Dario ; Barbagallo, Mario ; Paolisso, Giuseppe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c574t-f8036cae48400baa15d0b5020e59037b0265554cc158d82d47e5796f1ddc64e93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>Anthropometry</topic><topic>Arterial hypertension. 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Vascular system</topic><topic>Diabetes Mellitus - drug therapy</topic><topic>Diabetes Mellitus - physiopathology</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Fatty Acids, Nonesterified - blood</topic><topic>Female</topic><topic>free fatty acids</topic><topic>Glycated Hemoglobin A - drug effects</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Heart Rate - drug effects</topic><topic>Heart Rate - physiology</topic><topic>heart rate variability</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>insulin resistance</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metformin</topic><topic>Metformin - therapeutic use</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Obesity</topic><topic>Treatment Outcome</topic><topic>Triglycerides - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manzella, Daniela</creatorcontrib><creatorcontrib>Grella, Rodolfo</creatorcontrib><creatorcontrib>Esposito, Katherine</creatorcontrib><creatorcontrib>Giugliano, Dario</creatorcontrib><creatorcontrib>Barbagallo, Mario</creatorcontrib><creatorcontrib>Paolisso, Giuseppe</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of hypertension</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manzella, Daniela</au><au>Grella, Rodolfo</au><au>Esposito, Katherine</au><au>Giugliano, Dario</au><au>Barbagallo, Mario</au><au>Paolisso, Giuseppe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Blood pressure and cardiac autonomic nervous system in obese type 2 diabetic patients: effect of metformin administration</atitle><jtitle>American journal of hypertension</jtitle><addtitle>AJH</addtitle><date>2004-03-01</date><risdate>2004</risdate><volume>17</volume><issue>3</issue><spage>223</spage><epage>227</epage><pages>223-227</pages><issn>0895-7061</issn><eissn>1879-1905</eissn><eissn>1941-7225</eissn><coden>AJHYE6</coden><abstract>Hyperinsulinemia/insulin resistance and elevated plasma free fatty acids (FFA) levels are involved in the hypertension and cardiac sympathetic overactivity. Metformin improves insulin action and lower plasma FFA concentrations. We investigate the possible effect of metformin on arterial blood pressure (BP) and cardiac sympathetic nervous system.
One hundred twenty overweight type 2 diabetic patients were treated by placebo (
n = 60) + diet or metformin (850 mg twice daily) (
n = 60) + diet for 4 months, to evaluate the effect of metformin treatment on the cardiac autonomic nervous system. Insulin resistance was measured by the Homeostasis Model Assessment (HOMA) index. Heart rate variability (HRV) assessed cardiac sympathovagal balance.
Metformin treatment, but not placebo treatment, was associated with a decrease in fasting plasma glucose (
P < .05), insulin (
P < .05), triglyceride (
P < .05), and FFA (
P < .03) concentrations and HOMA index (
P < .03). Metformin treatment was also associated with a significant improvement in cardiac sympathovagal balance but not in mean arterial BP. Furthermore, in a multivariate analysis, delta change in sympathovagal balance index (LF/HF ratio) were associated with delta change in plasma FFA concentrations and HOMA index independently of gender and delta change in plasma triglyceride and HbA1c concentrations.
Our study demonstrated that metformin treatment might be useful for improving cardiac sympathovagal balance in obese type 2 diabetic patients.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15001195</pmid><doi>10.1016/j.amjhyper.2003.11.006</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0895-7061 |
| ispartof | American journal of hypertension, 2004-03, Vol.17 (3), p.223-227 |
| issn | 0895-7061 1879-1905 1941-7225 |
| language | eng |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE |
| subjects | Aged Anthropometry Arterial hypertension. Arterial hypotension Autonomic Nervous System - drug effects Autonomic Nervous System - physiology Biological and medical sciences Biomarkers - blood Blood and lymphatic vessels Blood Glucose - drug effects Blood Glucose - metabolism blood pressure Blood Pressure - drug effects Blood Pressure - physiology Cardiology. Vascular system Diabetes Mellitus - drug therapy Diabetes Mellitus - physiopathology Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - physiopathology Fatty Acids, Nonesterified - blood Female free fatty acids Glycated Hemoglobin A - drug effects Glycated Hemoglobin A - metabolism Heart Rate - drug effects Heart Rate - physiology heart rate variability Humans Hypoglycemic Agents - therapeutic use insulin resistance Male Medical sciences Metformin Metformin - therapeutic use Middle Aged Multivariate Analysis Obesity Treatment Outcome Triglycerides - blood |
| title | Blood pressure and cardiac autonomic nervous system in obese type 2 diabetic patients: effect of metformin administration |
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