Short-term treatment with metformin improves the cardiovascular risk profile in first-degree relatives of subjects with type 2 diabetes mellitus who have a metabolic syndrome and normal glucose tolerance without changes in C-reactive protein or fibrinogen.
OBJECTIVE
To study if metformin, when administered to first-degree relatives of type 2 diabetes mellitus subjects who have metabolic syndrome and normal glucose tolerance, could improve the cardiovascular risk profile and reduce the levels of both C-reactive protein and fibrinogen.


BACKGROUND
Metabolic syndrome is associated with higher cardiovascular morbidity and mortality. Metformin has vasculo-protective effects even in normoglycemic subjects, and C-reactive protein and fibrinogen are considered markers of endothelial injury and inflammation.


METHODS
Thirty-one non-diabetic first-degree relatives of type 2 diabetes mellitus subjects with metabolic syndrome were randomized (1:1) and double-blinded for placement in the placebo and metformin groups (850 mg bid/+/-90 days); 16 subjects were administered metformin (mean age 40.0 [33.5-50] years; 13 females) and 15 subjects were in the placebo group (mean age 37.0 [32-42] years; 9 females). Blood samples were collected at baseline and at the end of treatment for biochemical analyses, including an assessment of C-reactive protein and fibrinogen levels.


RESULTS
Metformin improved the lipid profile and decreased fasting plasma glucose, systolic blood pressure, weight and body mass index without changing body composition. For those in the placebo we identified no changes in fibrinogen (282.2 [220.4-323.7] mg/L vs. 286.7 [249.6-295.1] mg/L; NS) or in C-reactive protein levels (0.68 [0.3-1.2] vs. 0.64 [0.3-1.0] mg/L; NS). The same was also observed for the levels of fibrinogen (303.9 [217.6-347.6] mg/L vs. 290.9 [251.5-301.9] mg/L; NS) and C-reactive proteins (0.78 [0.3-1.1] vs. 0.80 [0.4-0.9] mg/L; NS) in the metformin group.


CONCLUSIONS
Metformin treatment in first-degree relatives of type 2 diabetes mellitus sufferers who have metabolic syndrome and normal glucose tolerance improved the cardiovascular risk profile without changing the levels of C-reactive protein and fibrinogen.
Lima
Luis Mauro Alvim de
LM
Laboratório de Pesquisas Clínica e Experimental em Biologia Vascular, Departamento de Clínica Médica, Centro Biomédico, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Wiernsperger
Nicolas
N
Kraemer-Aguiar
Luiz Guilherme
LG
Bouskela
Eliete
E
D000328:Adult; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000235:genetics; D004311:Double-Blind Method; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000494:pharmacology; D008297:Male; D024821:Metabolic Syndrome / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism*; D008687:Metformin / Q000009:adverse effects* / Q000494:pharmacology; D008875:Middle Aged; D010375:Pedigree; D012307:Risk Factors; D018709:Statistics, Nonparametric
D015415:Biomarkers; D007004:Hypoglycemic Agents; D005340:Fibrinogen; D002097:C-Reactive Protein; D008687:Metformin