Effects of Metformin on Left Ventricular Size and Function in Hypertensive Patients with Type 2 Diabetes Mellitus: Results of a Randomized, Controlled, Multicenter, Phase IV Trial

被引：5

作者：

Ono, Koh ^{[1
,2
]}

Wada, Hiromichi ^{[1
]}

Satoh-Asahara, Noriko ^{[1
]}

Inoue, Hitoki ^{[3
]}

Uehara, Keita ^{[4
]}

Funada, Junichi ^{[5
]}

Ogo, Atsushi ^{[6
]}

Horie, Takahiro ^{[2
]}

Fujita, Masatoshi ^{[7
]}

Shimatsu, Akira ^{[1
]}

Hasegawa, Koji ^{[1
]}

机构：

[1] Natl Hosp Org Kyoto Med Ctr, Clin Res Inst, Fushimi Ku, 1-1 Mukaihata Cho, Kyoto 6128555, Japan

[2] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, Sakyo Ku, 54 Shogoin Kawahara Cho, Kyoto 6068507, Japan

[3] Natl Hosp Org Hokkaido Canc Ctr, Dept Cardiol, Shiraishi Ku, 2-3-54 Kikusuishijyo, Sapporo, Hokkaido 0030804, Japan

[4] Natl Hosp Org Tochigi Med Ctr, Dept Gastroenterol, 1-10-37 Nakatomatsuri, Utsunomiya, Tochigi 3208580, Japan

[5] Natl Hosp Org Ehime Med Ctr, Dept Cardiol, 366 Yokogawara, Toon, Ehime 7910281, Japan

[6] Natl Hosp Org Kyushu Med Ctr, Clin Res Inst, Dept Metab & Endocrinol, Fukuoka, Fukuoka, Japan

[7] Uji Hosp, Dept Cardiovasc Med, Uji, Kyoto, Japan

来源：

AMERICAN JOURNAL OF CARDIOVASCULAR DRUGS | 2020年 / 20卷 / 03期

关键词：

HEART-FAILURE; INHIBITION; DISEASES; OUTCOMES; RISK;

D O I：

10.1007/s40256-019-00381-1

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Metformin 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. Objective The 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. Methods A 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. Results We 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. Conclusion LV 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.

引用

页码：283 / 293

页数：11

共 34 条

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