Background: Due to its efficacy and safety, metformin is the most commonly used drug in a single-agent therapy of type 2 diabetes mellitus (T2DM), after lifestyle modifications failed to obtain a desirable effects. Despite his main effects in improving glycemic control, it is also stated that it has a beneficial effects on lipid profile, which may be attributable to improved insulin sensitivity, weight loss and reduction of irreversibly glycated low density lipoprotein cholesterol (LDL-C). Clinical implication of these pleiotropic actions is on potential attenuation of cardiovascular events in T2DM.
Objective: To investigate possible correlation between daily dose of metformin used as a monotherapy and a lipid profile in patients with T2DM.
Methodology: A multi-center observational epidemiological survey included patients with T2DM who were treated with metformin as a monotherapy for at least 6 months. Demographic information, anthropometric measurements, fasting plasma glucose (FPG), glycosylated hemoglobin A1c (HbA1c), cholesterol, tryglicerides, high density lipoprotein cholesterol (HDL-C) and LDL-C are recorded and data statistically analizied.
Results: The study enrolled a total of 184 patients, aged between 30 and 85 years (mean 60.55±10.05 years), of whom 75 (40.8%) male and 109 (59.2%) female, with mean body mass index 29.15±4.46 kg/m2 and average HbA1c of 6.78% (range between 4.8-14.1%). Among them, the mean level of LDL-C was 3.47 mmol/l while the median daily dose of metformin was 1429.6 mg. No significant correlations are observed between metformin dose and levels of cholesterol, triglycerides, HDL-C and LDL-C. Significant positive, weak to moderate, correlation is observed between HbA1c and LDL-C (rho=0.237; P=0.002) but dispersion of extreme values makes difficult to evaluate this correlation better.
Conclusion: Patients with T2DM on metformin, administered as a monotherapy, may benefit not just from its effect on glycemic control but also from its influence on altered lipid profile which may further reduce cardiovascular risk. Based on this survey, this effect seems to be dosage-independent but larger studies are required to examine this association.
18 - 21 May 2019
European Society of Endocrinology