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Metformin Enhances Clearance of Chylomicrons and Chylomicron Remnants in Nondiabetic Mildly Overweight Glucose-Intolerant Subjects

  1. Itamar Grosskopf, MD,
  2. Yehuda Ringel, MD,
  3. Gideon Charach, MD,
  4. Nitsan Maharshak, MD,
  5. Ronit Mor, MD,
  6. Adrian Iaina, MD and
  7. Moshe Weintraub, MD
  1. Department of Internal Medicine C, Tel Aviv Sourasky Medical Center and the Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
  1. Address correspondence and reprint requests to Moshe Weintraub, MD, Department of Internal Medicine C, Tel Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 64239, Israel.

Abstract

OBJECTIVE To assess the effect of metformin on the metabolism of intestinally derived lipoproteins in nondiabetic individuals who were mildly overweight and glucose intolerant.

RESEARCH DESIGN AND METHODS A total of nine subjects with a BMI ≥ 25 kg/m2 and fasting serum glucose ≤ 6.1 mmol/l and who were glucose intolerant were studied. The subjects underwent a vitamin A fat-loading test before and after a 3-month treatment with 850 mg metformin twice a day. The metabolic behavior of the postprandial lipoproteins was compared with that found in a group of 19 healthy normolipidemic individuals who participated in a previous study.

RESULTS Mean total plasma, chylomicron fraction, and nonchylomicron fraction retinyl palmitate (RP) pretreatment levels were 3.4-fold, 3.59-fold, and 3-fold higher, respectively, in the study group than in the normolipidemic group and were reduced by 50, 56, and 32%, respectively, after 3 months of metformin treatment. The decrease of chylomicron levels after treatment was positively correlated to the fasting triglyceride values before treatment (r = 0.73, P = 0.039) and to the serum insulin level at 120 min of standard glucose loading before treatment (r = 0.91, P = 0.002).

CONCLUSIONS Metformin was shown to be beneficial in the clearance of postprandial lipoproteins in nondiabetic individuals who were mildly overweight and glucose intolerant.

  • Received November 18, 1996.
  • Accepted June 20, 1997.
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