![]() Subjects were provided isocaloric meals (~55% carbohydrate, 30% fat, and 15% protein multiplied by 1.3 activity factor) 24 hours before baseline and week 12 measurements. Given the opposing effects on insulin sensitivity we observed in this same study group ( 19), we hypothesized that the combined treatment would oppose the reduction in CVD risk compared to either treatment alone.īlood pressure, lipids and high sensitivity-CRP Therefore, the purpose of this study was to determine the effects of combining metformin with exercise training, compared to either treatment alone, on reducing CVD risk factors in men and women with IGT. Since insulin resistance is believed to be a key underlying factor causing metabolic syndrome (formerly syndrome X), it is important to understand the effects of metformin on CVD risk after exercise training ( 20). Adding to the uncertainty, we recently showed that metformin blunted the effects of training on insulin sensitivity in men and women with IGT ( 19). However, the interactions between exercise and metformin on CVD risk factors have not been systematically evaluated ( 17, 18). hypertension, elevated triacylglycerol, low HDL, fasting hyperglycemia, etc.) be considered for metformin treatment while participating in a regular exercise program ( 16). Because the actions of exercise and metformin are potentially additive, it has been suggested that individuals with IGT and at least 1 CVD risk factor (e.g. Metformin treatment can also increase insulin sensitivity ( 12, 13) and additionally, reduces fasting hyperglycemia and body weight ( 14, 15). triacylglycerol, low-density lipoproteins, etc.), blood pressure, and C-reactive protein ( 9, 10, 11). The mechanisms by which exercise lowers CVD risk likely involve increasing insulin sensitivity ( 6, 7, 8) and lowering circulating lipids (e.g. Treatments that raise insulin sensitivity or lower body weight may lower CVD risk in individuals with IGT. CVD risk is largely explained by insulin resistance and excess body weight ( 4, 5). hypertensive, hyperglycemic, and dyslipidemic) ( 3). Individuals with impaired glucose tolerance (IGT) are at elevated risk for cardiovascular disease (CVD) ( 1, 2) and approximately half of these individuals have metabolic syndrome (i.e. Thus, metformin may attenuate the effects of training on some CVD risk factors and metabolic syndrome severity in IGT adults. ![]() Although exercise and/or metformin improve some CVD risk factors, only training or metformin alone lowered hs-CRP and BP. Treatments raised HDL-cholesterol (p < 0.05 EM: trend p = 0.06) compared to P and lowered triacyglycerol (p < 0.05) and metabolic syndrome Z-score compared to baseline (EP trend p = 0.07 and EM or M p < 0.05). M and EP lowered systolic BP by 6% (p < 0.05), diastolic BP by 6% (p < 0.05), and hs-CRP by 20% (M: trend p = 0.06 EP: p < 0.05) compared to P. M and EM, but not EP, decreased body weight compared to P (p <0.05). Z-scores were calculated to determine metabolic syndrome severity. Outcomes included: adiposity, blood pressure (BP), lipids and high sensitivity C-reactive protein (hs-CRP). In a double-blind design, P or 2000mg/d of M were administered for 12 weeks and half performed aerobic and resistance training 3 days/week for approximately 60 minutes/day at 70% pre-training heart rate peak. Subjects were assigned to: placebo (P), metformin (M), exercise plus placebo (EP), or exercise plus metformin (EM) (8/group). To determine the effects of exercise training plus metformin, compared to each treatment alone, on CVD risk factors in IGT adults. Exercise or metformin reduce CVD risk, but the efficacy of combining treatments is unclear. Impaired glucose tolerant (IGT) adults are at elevated risk for cardiovascular disease (CVD).
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