Effects of Metformin Treatment on Myocardial and Endothelial Function in Insulin Resistance Patients: A Metabolomic StudyChristian Cadeddu1*, Martino Deidda1, Silvio Nocco1, Emanuela Locci2, Efisio Cossu2, Marco G Baroni1, Luigi Atzori2 and Giuseppe Mercuro1
- *Corresponding Author:
- Christian Cadeddu
Department of Medical Sciences “M Aresu”
University Hospital of Cagliari, StradaStatale 554
Km 4.500, 09042 Monserrato (Cagliari), Italy
Tel/Fax: (00 39) 070 675-4955/4991
E-mail: [email protected]
Received date: June 23, 2013; Accepted date: August 13, 2013; Published date: August 17, 2013
Citation: Cadeddu C, Deidda M, Nocco S, Locci E, Cossu E, et al. (2013) Effects of Metformin Treatment on Myocardial and Endothelial Function in Insulin Resistance Patients: A Metabolomic Study. J Diabetes Metab 4:279. doi: 10.4172/2155-6156.1000279
Copyright: © 2013 Cadeddu C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Insulin resistance (IR) adversely affects cardiac performance and peripheral vasodilation reserve. Metformin, prescribed to prevent the progression of IR resistance into diabetes, has been shown to improve myocardial performance and endothelial function in insulin resistant individuals. Metabolomics in the study of the metabolite profile of a biological organism proved its efficacy in detecting metabolites changes as a result of a therapeutic intervention and, so, predicting the response.
Aim: To evaluate myocardial and endothelium-dependent vasodilatory functions in an IR population subsequent to treatment with metformin and to determine the metabolic changes associated.
Methods: Twenty consecutive patients recently diagnosed with IR were studied. All subjects underwent echocardiography with Speckle Tracking technique, peripheral arterial tonometry to measure the endothelial flow reserve (EFR) and metabolomic analysis by 1H Nuclear Magnetic Resonance (NMR) spectroscopy and multivariate analysis at baseline and after metformin treatment.
Results: Inter-test comparison performed at baseline and after 3 months of metformin showed a significant reduction in weight (79 ± 15.4 vs 80.9 ± 16.2, P<0.05) and BMI (29.7 ± 5.3 vs 30.8 ± 5.2, p<0.05). Moreover we evidenced a significant increase in EFR (2.1 ± 0.43 vs 1.88 ± 0.47, p<0.05), and of the Global Longitudinal Strain (20.2 ± 4.21% vs 15.4 ± 3.06%, p<0.001).
PLS-DA analysis of the metabolic profile detected by NMR identified two groups significantly different (cross validation p-value=0.005). More significant discriminating metabolites were: lactate, lipids, N.acetyl glycoproteins, valine, choline, betaine,creatine.
Conclusions: The data obtained show that in IR subjects metformin improves myocardial and endothelial function. This effect was associated to significant metabolic changes characterized by means of a metabolomic approach.