Sustained benefits of metformin therapy on markers of cardiovascular risk in human immunodeficiency virus-infected patients with fat redistribution and insulin resistance
Sustained benefits of metformin therapy on markers of cardiovascular risk in human immunodeficiency virus-infected patients with fat redistribution and insulin resistance
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DOI：
10.1210/jc.2002-020709
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发表时间：
2002-10-01
影响因子：
5.8
通讯作者：
Grinspoon, S
中科院分区：
文献类型：
--
作者：
Hadigan, C;Rabe, J;Grinspoon, S
本研究的目的是评估持续二甲双胍治疗艾滋病毒感染的脂肪营养不良患者的代谢和心血管益处。参加为期3个月的随机研究的符合条件的受试者接受额外6个月的开放标签二甲双胍治疗延长。根据预先建立的安全性和有效性标准，25名潜在受试者中有19名有资格接受开放标签二甲双胍。胰岛素和葡萄糖对口服葡萄糖挑战的反应、心血管疾病风险标志物（如组织纤溶酶原激活物）、体重和人体测量是主要的结果测量指标。继续使用二甲双胍治疗导致组织纤溶酶原激活物抗原水平（P = 0.02）和体重指数（P = 0.03）进一步显著降低。在6个月的延长治疗期间，胰岛素水平持续下降。此外，持续二甲双胍治疗的受试者腰围显著降低（P = 0.01）。二甲双胍耐受性良好，没有人因副作用而停止治疗。这些数据表明，二甲双胍治疗在降低HIV感染和脂肪营养不良患者的高胰岛素血症和某些心血管疾病风险标志物方面具有持续的益处。
The purpose of this study was to evaluate the metabolic and cardiovascular benefits of continued metformin therapy for HIV-infected patients with lipodystrophy. Eligible subjects who participated in the 3-month randomized study received an additional 6-month open label metformin treatment extension. Nineteen of the 25 potential subjects were eligible to receive open label metformin based on preestablished safety and efficacy criteria. Insulin and glucose response to oral glucose challenge, cardiovascular disease risk markers (e.g. tissue plasminogen activator), weight, and anthropometric measurements were the primary outcome measures. Continued treatment with metformin resulted in further significant reductions in tissue plasminogen activator antigen levels (P = 0.02) and body mass index (P = 0.03). Reductions in insulin levels were sustained during the 6-month treatment extension. In addition, waist circumference decreased significantly in subjects continuing metformin treatment (P = 0.01). Metformin was well tolerated and no one discontinued treatment due to side effects. These data demonstrate a sustained benefit of metformin treatment to reduce hyperinsulinemia and certain markers of cardiovascular disease risk in patients with HIV infection and lipodystrophy.