Effects of Metformin on Left Ventricular Size and Function in Hypertensive Patients with Type 2 Diabetes Mellitus: Results of a ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2019-11-13

AUTHORS

Koh Ono, Hiromichi Wada, Noriko Satoh-Asahara, Hitoki Inoue, Keita Uehara, Junichi Funada, Atsushi Ogo, Takahiro Horie, Masatoshi Fujita, Akira Shimatsu, Koji Hasegawa

ABSTRACT

BackgroundMetformin 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.ObjectiveThe 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.MethodsA 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.ResultsWe 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.ConclusionLV 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 RegistrationUMIN000006504. Registered 7 October 2011. More... »

PAGES

283-293

Journal

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s40256-019-00381-1

DOI

http://dx.doi.org/10.1007/s40256-019-00381-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1122512677

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31721026


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29 schema:description BackgroundMetformin 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.ObjectiveThe 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.MethodsA 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.ResultsWe 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.ConclusionLV 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 RegistrationUMIN000006504. Registered 7 October 2011.
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36 BackgroundMetformin
37 Controlled
38 LDL-C levels
39 LV diastolic function
40 LV mass index
41 Randomized
42 ResultsWe
43 T2DM
44 agents
45 aim
46 antihyperglycemic agents
47 baseline
48 beneficial effects
49 benefits
50 body mass index
51 brain natriuretic peptide levels
52 changes
53 cholesterol
54 clinical findings
55 control group
56 creatinine
57 data
58 diabetes mellitus
59 diastolic function
60 effect
61 effect of metformin
62 endpoint
63 examination data
64 failure
65 filtration rate
66 findings
67 function
68 glomerular filtration rate
69 group
70 heart failure
71 history
72 history of hypertension
73 hypertension
74 hypertensive patients
75 hypoglycemic agents
76 index
77 indicators
78 laboratory examination data
79 left ventricular size
80 levels
81 lipoprotein cholesterol
82 low-density lipoprotein cholesterol
83 mass
84 mass index
85 mellitus
86 metformin
87 metformin treatment
88 metformin-treated group
89 multicenter
90 natriuretic peptide levels
91 oral antihyperglycemic agents
92 overt heart failure
93 patients
94 peptide levels
95 phase IV trial
96 possible benefits
97 precautions
98 preservation
99 primary endpoint
100 rate
101 reduction
102 renal function
103 results
104 serum creatinine
105 significant changes
106 significant reduction
107 size
108 study
109 terms
110 terms of reduction
111 total
112 treatment
113 trials
114 type 2
115 type 2 diabetes mellitus
116 unstable heart failure
117 use
118 ventricular mass index
119 ventricular size
120 years
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