title: Effects of metformin and exercise training, alone or in association, on cardio-pulmonary performance and quality of life in insulin resistance patients.
abstract: Metformin (MET) therapy exerts positive effects improving glucose tolerance and preventing the evolution toward diabetes in insulin resistant patients. It has been shown that adding MET to exercise training does not improve insulin sensitivity. The aim of this study was to determine the effect of MET and exercise training alone or in combination on maximal aerobic capacity and, as a secondary end-point on quality of life indexes in individuals with insulin resistance.
  
  
  
  75 insulin resistant patients were enrolled and subsequently assigned to MET (M), MET with exercise training (MEx), and exercise training alone (Ex). 12-weeks of supervised exercise-training program was carried out in both Ex and MEx groups. Cardiopulmonary exercise test and SF-36 to evaluate Health-Related Quality of Life (HRQoL) was performed at basal and after 12-weeks of treatment.
  
  
  
  Cardiopulmonary exercise test showed a significant increase of peak VO2 in Ex and MEx whereas M showed no improvement of peak VO2 (∆ VO2 [CI 95%] Ex +0.26 [0.47 to 0.05] l/min; ∆ VO2 MEx +0.19 [0.33 to 0.05] l/min; ∆ VO2 M -0.09 [-0.03 to -0.15] l/min; M vs E p < 0.01; M vs MEx p < 0.01; MEx vs Ex p = ns). SF-36 highlighted a significant increase in general QoL index in the MEx (58.3 ± 19 vs 77.3 ± 16; p < 0.01) and Ex (62.1 ± 17 vs 73.7 ± 12; p < 0.005) groups.
  
  
  
  We evidenced that cardiopulmonary negative effects showed by MET therapy may be counterbalanced with the combination of exercise training. Given that exercise training associated with MET produced similar effects to exercise training alone in terms of maximal aerobic capacity and HRQoL, programmed exercise training remains the first choice therapy in insulin resistant patients.
authors.affiliation: Department of Medical Sciences "M, Aresu", University Hospital of Cagliari, SS 554, Km 4,500, 09042 Monserrato, Italy. cadedduc@unica.it.
authors.forename: Christian
authors.initials: C
authors.lastname: Cadeddu
authors.forename: Silvio
authors.initials: S
authors.lastname: Nocco
authors.forename: Lucia
authors.initials: L
authors.lastname: Cugusi
authors.forename: Martino
authors.initials: M
authors.lastname: Deidda
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bina
authors.forename: Orru
authors.initials: O
authors.lastname: Fabio
authors.forename: Stefano
authors.initials: S
authors.lastname: Bandinu
authors.forename: Efisio
authors.initials: E
authors.lastname: Cossu
authors.forename: Marco Giorgio
authors.initials: MG
authors.lastname: Baroni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mercuro
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D015444:Exercise / Q000502:physiology* / Q000523:psychology; D005080:Exercise Test / Q000187:drug effects / Q000379:methods*; D017079:Exercise Tolerance / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology* / Q000627:therapeutic use; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008687:Metformin / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin