Limits...
Effects of metformin on the regulation of free Fatty acids in insulin resistance: a double-blind, placebo-controlled study.

Castro Cabezas M, van Wijk JP, Elte JW, Klop B - J Nutr Metab (2012)

Bottom Line: Fasting plasma glucose, FFA, and HOMA-IR tended to decrease after metformin, suggesting improved insulin sensitivity.The decrease in fasting plasma FFAs was positively associated to the decrease in HbA1c (r = 0.70; P = 0.03) and in fasting glucose (r = 0.74; P = 0.01).Metformin most likely decreases plasma FFAs mainly by suppressing fasting FFA concentrations and not by suppression of acute stress-induced lipolysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Sint Franciscus Gasthuis Rotterdam, P.O. Box 10900, 3004 BA Rotterdam, The Netherlands.

ABSTRACT
Introduction. Impaired free fatty acid (FFA) metabolism is closely linked to insulin resistance. Our aim was to evaluate plasma FFA changes in insulin resistance in a physiological situation after improvement of insulin sensitivity by metformin. Methods. A double-blind, placebo-controlled intervention with metformin was carried out in patients with insulin resistance. Nineteen patients were randomized to receive metformin 850 mg b.i.d. during 6 weeks or placebo. Participants underwent a mental stress test and an oral glucose tolerance test (OGTT) before and after treatment. Results. Fasting plasma glucose, FFA, and HOMA-IR tended to decrease after metformin, suggesting improved insulin sensitivity. FFA concentrations during the mental stress test showed a similar pattern after metformin, albeit lower at all time points, in contrast to the placebo group. The decrease in fasting plasma FFAs was positively associated to the decrease in HbA1c (r = 0.70; P = 0.03) and in fasting glucose (r = 0.74; P = 0.01). The suppression of plasma FFAs during OGTT did not change by metformin or placebo. Conclusion. Metformin in insulin resistance did not lead to improved FFA dynamics despite a trend of improved insulin sensitivity. Metformin most likely decreases plasma FFAs mainly by suppressing fasting FFA concentrations and not by suppression of acute stress-induced lipolysis.

No MeSH data available.


Related in: MedlinePlus

Mean changes in free fatty acid (FFA) concentrations during the mental-stress test (MST) in insulin resistant patients at baseline and after six weeks of treatment with metformin (N = 10) (a) or placebo (N = 9) (b). Data represent the mean ± SEM.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3475305&req=5

fig1: Mean changes in free fatty acid (FFA) concentrations during the mental-stress test (MST) in insulin resistant patients at baseline and after six weeks of treatment with metformin (N = 10) (a) or placebo (N = 9) (b). Data represent the mean ± SEM.

Mentions: Nineteen patients with insulin resistance completed the study. Five patients with type 2 diabetes mellitus were included in the metformin group and two in the placebo group. The general characteristics of the participants are given in Table 1. There were no significant differences between the groups. After 6 weeks of treatment with metformin, fasting free fatty acids, plasma glucose, HbA1c, HOMA-IR, and total cholesterol tended to decrease without reaching statistical significance. Metformin tended to decrease fasting plasma FFA from 0.61 ± 0.08 to 0.44 ± 0.06 mmol/L (P = 0.06) in contrast to placebo (from 0.58 ± 0.22 to 0.55 ± 0.07 mmol/L), suggesting improved insulin sensitivity by metformin. In the placebo group, all fasting plasma variables remained unchanged.


Effects of metformin on the regulation of free Fatty acids in insulin resistance: a double-blind, placebo-controlled study.

Castro Cabezas M, van Wijk JP, Elte JW, Klop B - J Nutr Metab (2012)

Mean changes in free fatty acid (FFA) concentrations during the mental-stress test (MST) in insulin resistant patients at baseline and after six weeks of treatment with metformin (N = 10) (a) or placebo (N = 9) (b). Data represent the mean ± SEM.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3475305&req=5

fig1: Mean changes in free fatty acid (FFA) concentrations during the mental-stress test (MST) in insulin resistant patients at baseline and after six weeks of treatment with metformin (N = 10) (a) or placebo (N = 9) (b). Data represent the mean ± SEM.
Mentions: Nineteen patients with insulin resistance completed the study. Five patients with type 2 diabetes mellitus were included in the metformin group and two in the placebo group. The general characteristics of the participants are given in Table 1. There were no significant differences between the groups. After 6 weeks of treatment with metformin, fasting free fatty acids, plasma glucose, HbA1c, HOMA-IR, and total cholesterol tended to decrease without reaching statistical significance. Metformin tended to decrease fasting plasma FFA from 0.61 ± 0.08 to 0.44 ± 0.06 mmol/L (P = 0.06) in contrast to placebo (from 0.58 ± 0.22 to 0.55 ± 0.07 mmol/L), suggesting improved insulin sensitivity by metformin. In the placebo group, all fasting plasma variables remained unchanged.

Bottom Line: Fasting plasma glucose, FFA, and HOMA-IR tended to decrease after metformin, suggesting improved insulin sensitivity.The decrease in fasting plasma FFAs was positively associated to the decrease in HbA1c (r = 0.70; P = 0.03) and in fasting glucose (r = 0.74; P = 0.01).Metformin most likely decreases plasma FFAs mainly by suppressing fasting FFA concentrations and not by suppression of acute stress-induced lipolysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Center for Diabetes and Vascular Medicine, Sint Franciscus Gasthuis Rotterdam, P.O. Box 10900, 3004 BA Rotterdam, The Netherlands.

ABSTRACT
Introduction. Impaired free fatty acid (FFA) metabolism is closely linked to insulin resistance. Our aim was to evaluate plasma FFA changes in insulin resistance in a physiological situation after improvement of insulin sensitivity by metformin. Methods. A double-blind, placebo-controlled intervention with metformin was carried out in patients with insulin resistance. Nineteen patients were randomized to receive metformin 850 mg b.i.d. during 6 weeks or placebo. Participants underwent a mental stress test and an oral glucose tolerance test (OGTT) before and after treatment. Results. Fasting plasma glucose, FFA, and HOMA-IR tended to decrease after metformin, suggesting improved insulin sensitivity. FFA concentrations during the mental stress test showed a similar pattern after metformin, albeit lower at all time points, in contrast to the placebo group. The decrease in fasting plasma FFAs was positively associated to the decrease in HbA1c (r = 0.70; P = 0.03) and in fasting glucose (r = 0.74; P = 0.01). The suppression of plasma FFAs during OGTT did not change by metformin or placebo. Conclusion. Metformin in insulin resistance did not lead to improved FFA dynamics despite a trend of improved insulin sensitivity. Metformin most likely decreases plasma FFAs mainly by suppressing fasting FFA concentrations and not by suppression of acute stress-induced lipolysis.

No MeSH data available.


Related in: MedlinePlus