Metformin modifies the exercise training effects on risk factors for cardiovascular disease in impaired glucose tolerant adults

Obesity (Silver Spring). 2013 Jan;21(1):93-100. doi: 10.1002/oby.20235.

Abstract

Impaired glucose tolerant (IGT) adults are at elevated risk for cardiovascular disease (CVD). Exercise or metformin reduce CVD risk, but the efficacy of combining treatments is unclear.

Objective: To determine the effects of exercise training plus metformin (EM), compared with each treatment alone, on CVD risk factors in IGT adults.

Design and methods: Subjects were assigned to placebo (P), metformin (M), exercise training plus placebo (EP), or EM (8/group). In a double-blind design, P or 2,000 mg/d of M were administered for 12 weeks and half performed aerobic and resistance training 3 days/week for ≈ 60 min/day at 70% pretraining heart rate peak. Outcomes included adiposity, blood pressure (BP), lipids, and high sensitivity C-reactive protein (hs-CRP). Z-scores were calculated to determine metabolic syndrome severity.

Results: M and EM, but not EP, decreased body weight compared with P (P < 0.05). M and EP lowered systolic blood pressure by 6% (P < 0.05), diastolic blood pressure by 6% (P < 0.05), and hs-CRP by 20% (M: trend P = 0.06; EP: P < 0.05) compared with P. Treatments raised high-density lipoprotein cholesterol (P < 0.05; EM: trend P = 0.06) compared with P and lowered triacyglycerol (P < 0.05) and metabolic syndrome Z-score compared with baseline (EP; trend P = 0.07 and EM or M; P < 0.05).

Conclusions: Although exercise and/or metformin improve some CVD risk factors, only training or metformin alone lowered hs-CRP and BP. Thus, metformin may attenuate the effects of training on some CVD risk factors and metabolic syndrome severity in IGT adults.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adiposity
  • Adult
  • Blood Pressure / drug effects
  • C-Reactive Protein / metabolism
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cholesterol, HDL / blood
  • Double-Blind Method
  • Exercise / physiology*
  • Female
  • Glucose Intolerance / blood
  • Glucose Intolerance / complications
  • Glucose Intolerance / therapy*
  • Heart Rate
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / prevention & control*
  • Metformin / adverse effects
  • Metformin / pharmacology*
  • Metformin / therapeutic use
  • Middle Aged
  • Obesity / complications
  • Obesity / prevention & control*
  • Resistance Training
  • Risk Factors
  • Triglycerides / blood
  • Weight Loss*

Substances

  • Cholesterol, HDL
  • Hypoglycemic Agents
  • Triglycerides
  • C-Reactive Protein
  • Metformin