Effects of Metformin on Left Ventricular Size and Function in Hypertensive Patients with Type 2 Diabetes Mellitus: Results of a Randomized, Controlled, Multicenter, Phase IV Trial
Background Metformin is the most widely used oral antihyperglycemic agent for patients with type 2 diabetes mellitus (T2DM). Despite the possible benefits of metformin on diabetes mellitus (DM) and heart failure (HF), acute or unstable HF remains a precaution for its use. Objective The aim of the pr...
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| creator | Ono, Koh Wada, Hiromichi Satoh-Asahara, Noriko Inoue, Hitoki Uehara, Keita Funada, Junichi Ogo, Atsushi Horie, Takahiro Fujita, Masatoshi Shimatsu, Akira Hasegawa, Koji |
| description | Background
Metformin is the most widely used oral antihyperglycemic agent for patients with type 2 diabetes mellitus (T2DM). Despite the possible benefits of metformin on diabetes mellitus (DM) and heart failure (HF), acute or unstable HF remains a precaution for its use.
Objective
The aim of the present prospective randomized controlled trial was to assess whether metformin treatment has beneficial effects on patients with T2DM with hypertension without overt HF.
Methods
A total of 164 patients (92 males, 72 females; median age 66 years) were included in this study. Patients with T2DM with a history of hypertension were randomized 1:1 to treatment for 1 year with either metformin (metformin-treated group) or other hypoglycemic agents (control group). The primary endpoints were changes in brain natriuretic peptide (BNP) levels, left ventricular (LV) mass index, and indicators of LV diastolic function. We also evaluated changes in both clinical findings and blood laboratory examination data.
Results
We observed no significant changes between baseline and 1-year post-treatment in LV mass index, BNP levels, or
E
/
e
′ (early diastolic transmitral flow velocity/early diastolic mitral annular velocity; an indicator of LV diastolic function) in either the metformin-treated (
n
= 83) or the control (
n
= 81) groups. The metformin-treated group had a significant reduction of body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C), but the control group did not. We determined that renal function, including serum creatinine and estimated glomerular filtration rate, deteriorated significantly in the control group but not in the metformin-treated group.
Conclusion
LV mass and diastolic function were not affected after 1 year of metformin treatment in patients with T2DM. However, we observed benefits in terms of reductions in both BMI and LDL-C levels and preservation of renal function.
Trial Registration
UMIN000006504. Registered 7 October 2011. |
| doi_str_mv | 10.1007/s40256-019-00381-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7266803</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2410838283</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-bd6348012c3a3cb7398587cde8380ded75870291954a7db1355bae30d72e14cf3</originalsourceid><addsrcrecordid>eNp9kU9v1DAQxSMEoqXwBTigkbg24D_JOuGAVC0trbQVVVkqbpbjTLqusvFiO0Xt1-oXZLYpBS6cPNa8-b0nvSx7zdk7zph6HwsmylnOeJ0zJiue8yfZLueqznmlvj-9n8tcCqV2shcxXjHGlVD182xH0sCZmO1md4ddhzZF8B2cYup8WLsB_AAL7BJc4JCCs2NvAnx1twhmaOFoHGxyJCHh8c0GQ8IhumuEM5McHUT46dIKlrQCAZ-caTBhJHrfuzTGD3COcewnSwPnhPRrYrf7MPdk5_t-O5-SxFnCYdiHs5WJCCcXsAzO9C-zZ53pI756ePeyb0eHy_lxvvjy-WR-sMhtoYqUN-1MFhXjwkojbaNkXZWVsi1WsmIttop-TNS8Lguj2obLsmwMStYqgbywndzLPk7czdissd2GCabXm-DWJtxob5z-dzO4lb7011qJ2axikgBvHwDB_xgxJn3lxzBQZi0KziiHqLYqMals8DEG7B4dONPbovVUtKai9X3RmtPRm7-zPZ78bpYEchJEWg2XGP54_wf7C_EMto0</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2410838283</pqid></control><display><type>article</type><title>Effects of Metformin on Left Ventricular Size and Function in Hypertensive Patients with Type 2 Diabetes Mellitus: Results of a Randomized, Controlled, Multicenter, Phase IV Trial</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Ono, Koh ; Wada, Hiromichi ; Satoh-Asahara, Noriko ; Inoue, Hitoki ; Uehara, Keita ; Funada, Junichi ; Ogo, Atsushi ; Horie, Takahiro ; Fujita, Masatoshi ; Shimatsu, Akira ; Hasegawa, Koji</creator><creatorcontrib>Ono, Koh ; Wada, Hiromichi ; Satoh-Asahara, Noriko ; Inoue, Hitoki ; Uehara, Keita ; Funada, Junichi ; Ogo, Atsushi ; Horie, Takahiro ; Fujita, Masatoshi ; Shimatsu, Akira ; Hasegawa, Koji ; ABLE-MET Investigators ; the ABLE-MET Investigators</creatorcontrib><description>Background
Metformin is the most widely used oral antihyperglycemic agent for patients with type 2 diabetes mellitus (T2DM). Despite the possible benefits of metformin on diabetes mellitus (DM) and heart failure (HF), acute or unstable HF remains a precaution for its use.
Objective
The aim of the present prospective randomized controlled trial was to assess whether metformin treatment has beneficial effects on patients with T2DM with hypertension without overt HF.
Methods
A total of 164 patients (92 males, 72 females; median age 66 years) were included in this study. Patients with T2DM with a history of hypertension were randomized 1:1 to treatment for 1 year with either metformin (metformin-treated group) or other hypoglycemic agents (control group). The primary endpoints were changes in brain natriuretic peptide (BNP) levels, left ventricular (LV) mass index, and indicators of LV diastolic function. We also evaluated changes in both clinical findings and blood laboratory examination data.
Results
We observed no significant changes between baseline and 1-year post-treatment in LV mass index, BNP levels, or
E
/
e
′ (early diastolic transmitral flow velocity/early diastolic mitral annular velocity; an indicator of LV diastolic function) in either the metformin-treated (
n
= 83) or the control (
n
= 81) groups. The metformin-treated group had a significant reduction of body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C), but the control group did not. We determined that renal function, including serum creatinine and estimated glomerular filtration rate, deteriorated significantly in the control group but not in the metformin-treated group.
Conclusion
LV mass and diastolic function were not affected after 1 year of metformin treatment in patients with T2DM. However, we observed benefits in terms of reductions in both BMI and LDL-C levels and preservation of renal function.
Trial Registration
UMIN000006504. Registered 7 October 2011.</description><identifier>ISSN: 1175-3277</identifier><identifier>EISSN: 1179-187X</identifier><identifier>DOI: 10.1007/s40256-019-00381-1</identifier><identifier>PMID: 31721026</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Acidosis ; Aged ; Antidiabetics ; Blood pressure ; Body Mass Index ; Cardiology ; Cardiovascular disease ; Cholesterol, LDL - blood ; Clinical medicine ; Clinical trials ; Coma ; Contraindications ; Creatinine ; Diabetes ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - physiopathology ; Enzymes ; Female ; Flow velocity ; Heart failure ; Heart Ventricles - pathology ; Heart Ventricles - physiopathology ; Humans ; Hypertension ; Hypertension - complications ; Hypertension - diagnosis ; Hypertension - metabolism ; Hypoglycemic Agents - administration & dosage ; Hypoglycemic Agents - pharmacokinetics ; Kinases ; Laboratories ; Liver ; Male ; Medicine ; Medicine & Public Health ; Metformin - administration & dosage ; Metformin - pharmacokinetics ; Natriuretic Peptide, Brain - blood ; Organ Size - drug effects ; Original ; Original Research Article ; Peptides ; Pharmacology/Toxicology ; Pharmacotherapy ; Studies ; Treatment Outcome ; Variance analysis ; Ventricular Function, Left - drug effects</subject><ispartof>American journal of cardiovascular drugs : drugs, devices, and other interventions, 2020-06, Vol.20 (3), p.283-293</ispartof><rights>The Author(s) 2019</rights><rights>Copyright Springer Nature B.V. Jun 2020</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-bd6348012c3a3cb7398587cde8380ded75870291954a7db1355bae30d72e14cf3</citedby><cites>FETCH-LOGICAL-c474t-bd6348012c3a3cb7398587cde8380ded75870291954a7db1355bae30d72e14cf3</cites><orcidid>0000-0002-4163-980X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s40256-019-00381-1$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s40256-019-00381-1$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31721026$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ono, Koh</creatorcontrib><creatorcontrib>Wada, Hiromichi</creatorcontrib><creatorcontrib>Satoh-Asahara, Noriko</creatorcontrib><creatorcontrib>Inoue, Hitoki</creatorcontrib><creatorcontrib>Uehara, Keita</creatorcontrib><creatorcontrib>Funada, Junichi</creatorcontrib><creatorcontrib>Ogo, Atsushi</creatorcontrib><creatorcontrib>Horie, Takahiro</creatorcontrib><creatorcontrib>Fujita, Masatoshi</creatorcontrib><creatorcontrib>Shimatsu, Akira</creatorcontrib><creatorcontrib>Hasegawa, Koji</creatorcontrib><creatorcontrib>ABLE-MET Investigators</creatorcontrib><creatorcontrib>the ABLE-MET Investigators</creatorcontrib><title>Effects of Metformin on Left Ventricular Size and Function in Hypertensive Patients with Type 2 Diabetes Mellitus: Results of a Randomized, Controlled, Multicenter, Phase IV Trial</title><title>American journal of cardiovascular drugs : drugs, devices, and other interventions</title><addtitle>Am J Cardiovasc Drugs</addtitle><addtitle>Am J Cardiovasc Drugs</addtitle><description>Background
Metformin is the most widely used oral antihyperglycemic agent for patients with type 2 diabetes mellitus (T2DM). Despite the possible benefits of metformin on diabetes mellitus (DM) and heart failure (HF), acute or unstable HF remains a precaution for its use.
Objective
The aim of the present prospective randomized controlled trial was to assess whether metformin treatment has beneficial effects on patients with T2DM with hypertension without overt HF.
Methods
A total of 164 patients (92 males, 72 females; median age 66 years) were included in this study. Patients with T2DM with a history of hypertension were randomized 1:1 to treatment for 1 year with either metformin (metformin-treated group) or other hypoglycemic agents (control group). The primary endpoints were changes in brain natriuretic peptide (BNP) levels, left ventricular (LV) mass index, and indicators of LV diastolic function. We also evaluated changes in both clinical findings and blood laboratory examination data.
Results
We observed no significant changes between baseline and 1-year post-treatment in LV mass index, BNP levels, or
E
/
e
′ (early diastolic transmitral flow velocity/early diastolic mitral annular velocity; an indicator of LV diastolic function) in either the metformin-treated (
n
= 83) or the control (
n
= 81) groups. The metformin-treated group had a significant reduction of body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C), but the control group did not. We determined that renal function, including serum creatinine and estimated glomerular filtration rate, deteriorated significantly in the control group but not in the metformin-treated group.
Conclusion
LV mass and diastolic function were not affected after 1 year of metformin treatment in patients with T2DM. However, we observed benefits in terms of reductions in both BMI and LDL-C levels and preservation of renal function.
Trial Registration
UMIN000006504. Registered 7 October 2011.</description><subject>Acidosis</subject><subject>Aged</subject><subject>Antidiabetics</subject><subject>Blood pressure</subject><subject>Body Mass Index</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Cholesterol, LDL - blood</subject><subject>Clinical medicine</subject><subject>Clinical trials</subject><subject>Coma</subject><subject>Contraindications</subject><subject>Creatinine</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Enzymes</subject><subject>Female</subject><subject>Flow velocity</subject><subject>Heart failure</subject><subject>Heart Ventricles - pathology</subject><subject>Heart Ventricles - physiopathology</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - complications</subject><subject>Hypertension - diagnosis</subject><subject>Hypertension - metabolism</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Hypoglycemic Agents - pharmacokinetics</subject><subject>Kinases</subject><subject>Laboratories</subject><subject>Liver</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metformin - administration & dosage</subject><subject>Metformin - pharmacokinetics</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Organ Size - drug effects</subject><subject>Original</subject><subject>Original Research Article</subject><subject>Peptides</subject><subject>Pharmacology/Toxicology</subject><subject>Pharmacotherapy</subject><subject>Studies</subject><subject>Treatment Outcome</subject><subject>Variance analysis</subject><subject>Ventricular Function, Left - drug effects</subject><issn>1175-3277</issn><issn>1179-187X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kU9v1DAQxSMEoqXwBTigkbg24D_JOuGAVC0trbQVVVkqbpbjTLqusvFiO0Xt1-oXZLYpBS6cPNa8-b0nvSx7zdk7zph6HwsmylnOeJ0zJiue8yfZLueqznmlvj-9n8tcCqV2shcxXjHGlVD182xH0sCZmO1md4ddhzZF8B2cYup8WLsB_AAL7BJc4JCCs2NvAnx1twhmaOFoHGxyJCHh8c0GQ8IhumuEM5McHUT46dIKlrQCAZ-caTBhJHrfuzTGD3COcewnSwPnhPRrYrf7MPdk5_t-O5-SxFnCYdiHs5WJCCcXsAzO9C-zZ53pI756ePeyb0eHy_lxvvjy-WR-sMhtoYqUN-1MFhXjwkojbaNkXZWVsi1WsmIttop-TNS8Lguj2obLsmwMStYqgbywndzLPk7czdissd2GCabXm-DWJtxob5z-dzO4lb7011qJ2axikgBvHwDB_xgxJn3lxzBQZi0KziiHqLYqMals8DEG7B4dONPbovVUtKai9X3RmtPRm7-zPZ78bpYEchJEWg2XGP54_wf7C_EMto0</recordid><startdate>20200601</startdate><enddate>20200601</enddate><creator>Ono, Koh</creator><creator>Wada, Hiromichi</creator><creator>Satoh-Asahara, Noriko</creator><creator>Inoue, Hitoki</creator><creator>Uehara, Keita</creator><creator>Funada, Junichi</creator><creator>Ogo, Atsushi</creator><creator>Horie, Takahiro</creator><creator>Fujita, Masatoshi</creator><creator>Shimatsu, Akira</creator><creator>Hasegawa, Koji</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>C6C</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>4T-</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>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4163-980X</orcidid></search><sort><creationdate>20200601</creationdate><title>Effects of Metformin on Left Ventricular Size and Function in Hypertensive Patients with Type 2 Diabetes Mellitus: Results of a Randomized, Controlled, Multicenter, Phase IV Trial</title><author>Ono, Koh ; Wada, Hiromichi ; Satoh-Asahara, Noriko ; Inoue, Hitoki ; Uehara, Keita ; Funada, Junichi ; Ogo, Atsushi ; Horie, Takahiro ; Fujita, Masatoshi ; Shimatsu, Akira ; Hasegawa, Koji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-bd6348012c3a3cb7398587cde8380ded75870291954a7db1355bae30d72e14cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Acidosis</topic><topic>Aged</topic><topic>Antidiabetics</topic><topic>Blood pressure</topic><topic>Body Mass Index</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>Cholesterol, LDL - blood</topic><topic>Clinical medicine</topic><topic>Clinical trials</topic><topic>Coma</topic><topic>Contraindications</topic><topic>Creatinine</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Enzymes</topic><topic>Female</topic><topic>Flow velocity</topic><topic>Heart failure</topic><topic>Heart Ventricles - pathology</topic><topic>Heart Ventricles - physiopathology</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - complications</topic><topic>Hypertension - diagnosis</topic><topic>Hypertension - metabolism</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Hypoglycemic Agents - pharmacokinetics</topic><topic>Kinases</topic><topic>Laboratories</topic><topic>Liver</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metformin - administration & dosage</topic><topic>Metformin - pharmacokinetics</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Organ Size - drug effects</topic><topic>Original</topic><topic>Original Research Article</topic><topic>Peptides</topic><topic>Pharmacology/Toxicology</topic><topic>Pharmacotherapy</topic><topic>Studies</topic><topic>Treatment Outcome</topic><topic>Variance analysis</topic><topic>Ventricular Function, Left - drug effects</topic><toplevel>online_resources</toplevel><creatorcontrib>Ono, Koh</creatorcontrib><creatorcontrib>Wada, Hiromichi</creatorcontrib><creatorcontrib>Satoh-Asahara, Noriko</creatorcontrib><creatorcontrib>Inoue, Hitoki</creatorcontrib><creatorcontrib>Uehara, Keita</creatorcontrib><creatorcontrib>Funada, Junichi</creatorcontrib><creatorcontrib>Ogo, Atsushi</creatorcontrib><creatorcontrib>Horie, Takahiro</creatorcontrib><creatorcontrib>Fujita, Masatoshi</creatorcontrib><creatorcontrib>Shimatsu, Akira</creatorcontrib><creatorcontrib>Hasegawa, Koji</creatorcontrib><creatorcontrib>ABLE-MET Investigators</creatorcontrib><creatorcontrib>the ABLE-MET Investigators</creatorcontrib><collection>Springer Nature OA/Free Journals</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>Docstoc</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>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of cardiovascular drugs : drugs, devices, and other interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ono, Koh</au><au>Wada, Hiromichi</au><au>Satoh-Asahara, Noriko</au><au>Inoue, Hitoki</au><au>Uehara, Keita</au><au>Funada, Junichi</au><au>Ogo, Atsushi</au><au>Horie, Takahiro</au><au>Fujita, Masatoshi</au><au>Shimatsu, Akira</au><au>Hasegawa, Koji</au><aucorp>ABLE-MET Investigators</aucorp><aucorp>the ABLE-MET Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Metformin on Left Ventricular Size and Function in Hypertensive Patients with Type 2 Diabetes Mellitus: Results of a Randomized, Controlled, Multicenter, Phase IV Trial</atitle><jtitle>American journal of cardiovascular drugs : drugs, devices, and other interventions</jtitle><stitle>Am J Cardiovasc Drugs</stitle><addtitle>Am J Cardiovasc Drugs</addtitle><date>2020-06-01</date><risdate>2020</risdate><volume>20</volume><issue>3</issue><spage>283</spage><epage>293</epage><pages>283-293</pages><issn>1175-3277</issn><eissn>1179-187X</eissn><abstract>Background
Metformin is the most widely used oral antihyperglycemic agent for patients with type 2 diabetes mellitus (T2DM). Despite the possible benefits of metformin on diabetes mellitus (DM) and heart failure (HF), acute or unstable HF remains a precaution for its use.
Objective
The aim of the present prospective randomized controlled trial was to assess whether metformin treatment has beneficial effects on patients with T2DM with hypertension without overt HF.
Methods
A total of 164 patients (92 males, 72 females; median age 66 years) were included in this study. Patients with T2DM with a history of hypertension were randomized 1:1 to treatment for 1 year with either metformin (metformin-treated group) or other hypoglycemic agents (control group). The primary endpoints were changes in brain natriuretic peptide (BNP) levels, left ventricular (LV) mass index, and indicators of LV diastolic function. We also evaluated changes in both clinical findings and blood laboratory examination data.
Results
We observed no significant changes between baseline and 1-year post-treatment in LV mass index, BNP levels, or
E
/
e
′ (early diastolic transmitral flow velocity/early diastolic mitral annular velocity; an indicator of LV diastolic function) in either the metformin-treated (
n
= 83) or the control (
n
= 81) groups. The metformin-treated group had a significant reduction of body mass index (BMI) and low-density lipoprotein cholesterol (LDL-C), but the control group did not. We determined that renal function, including serum creatinine and estimated glomerular filtration rate, deteriorated significantly in the control group but not in the metformin-treated group.
Conclusion
LV mass and diastolic function were not affected after 1 year of metformin treatment in patients with T2DM. However, we observed benefits in terms of reductions in both BMI and LDL-C levels and preservation of renal function.
Trial Registration
UMIN000006504. Registered 7 October 2011.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31721026</pmid><doi>10.1007/s40256-019-00381-1</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-4163-980X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1175-3277 |
| ispartof | American journal of cardiovascular drugs : drugs, devices, and other interventions, 2020-06, Vol.20 (3), p.283-293 |
| issn | 1175-3277 1179-187X |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Acidosis Aged Antidiabetics Blood pressure Body Mass Index Cardiology Cardiovascular disease Cholesterol, LDL - blood Clinical medicine Clinical trials Coma Contraindications Creatinine Diabetes Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - physiopathology Enzymes Female Flow velocity Heart failure Heart Ventricles - pathology Heart Ventricles - physiopathology Humans Hypertension Hypertension - complications Hypertension - diagnosis Hypertension - metabolism Hypoglycemic Agents - administration & dosage Hypoglycemic Agents - pharmacokinetics Kinases Laboratories Liver Male Medicine Medicine & Public Health Metformin - administration & dosage Metformin - pharmacokinetics Natriuretic Peptide, Brain - blood Organ Size - drug effects Original Original Research Article Peptides Pharmacology/Toxicology Pharmacotherapy Studies Treatment Outcome Variance analysis Ventricular Function, Left - drug effects |
| title | Effects of Metformin on Left Ventricular Size and Function in Hypertensive Patients with Type 2 Diabetes Mellitus: Results of a Randomized, Controlled, Multicenter, Phase IV Trial |
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