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Diabetes interventions may decrease risk for CVD
Intensive lifestyle modification and metformin treatment significantly reduced risk for cardiovascular disease by favorably affecting lipid particles, recent data published in TheJournal of Clinical Endocrinology and Metabolism showed.
“Cardiovascular disease is the most significant cause of death and disability in people with diabetes,” researcher Ronald Goldberg, MD, of the University of Miami’s Miller School of Medicine, said in a press release. “Our findings demonstrate that the same therapies used to slow the onset of diabetes also may help allay the risk of heart disease.”
Goldberg and colleagues analyzed a subset of 1,645 participants with impaired glucose tolerance who were randomly assigned to metformin 850 mg twice daily, an intensive lifestyle modification program targeting a 7% weight loss or placebo as part of the Diabetes Prevention Program. Blood samples were obtained at baseline and after 1 year.
The researchers observed decreases in large and buoyant VLDL, small and dense LDL, and small HDL, as well as an increase in large HDL in the intensive lifestyle intervention group. In the metformin group, participants experienced modest reductions in small and dense LDL and increases in small and large HDL.
Results revealed a direct correlation between change in insulin resistance and intervention-associated decreases in large VLDL. In contrast, changes in LDL were strongly linked to BMI and adiponectin. Data also associated baseline and a change in adiponectin with change in large HDL, and change in BMI with change in small HDL. The effect of metformin on increases in small HDL, however, was independent of adiponectin, BMI and insulin resistance.
“Preventing or slowing the development of diabetes with these treatments also improves the cholesterol and triglyceride profile of a person’s blood. Thanks to the added benefits of existing diabetes interventions, we stand a better chance of lowering the risk of heart disease in this patient population,” Goldberg said in the release.
Disclosure: Goldberg has consulted for Daiichi, LipoScience and Merck, and served on an advisory board for Bristol-Myers Squibb/AstraZeneca. Another researcher is employed by and owns stock in LipoScience.