AN OPEN PILOT STUDY TO EVALUATE THE EFFECTS OF METFORMIN AND LIFE STYLE CHANGES ON SERUM PARAOXONASE ACTIVITY AND OXIDATIVE STRESS MARKERS IN PREMENOPAUSAL, OBESE, INSULIN RESISTANT WOMEN

作者：Fenkci S^*; Karagenc N; Fenkci V

来源：Acta Endocrinologica-Bucharest, 2012, 8(3): 403-412.

DOI：10.4183/aeb.2012.403

• paraoxonase
• metformin
• oxidative stress
• insulin resistance
• obesity

Background. The prevention of type 2 diabetes has great clinical importance. Many pharmacologic and non-pharmacologic methods are used to prevent type 2 DM. Metformin reduces the risk of developing diabetes in insulin resistant subjects. Oxidative stress plays pivotal roles in the pathogenesis and complications of diabetes mellitus. Paraoxonase 1 has antioxidant capacity.
Objective. This study was planned to assess the effects of metformin and life style changes on paraoxonase activity and oxidative stress markers in premenopausal, obese, insulin resistant women.
Design.Open-pilot clinical study.
Subjects and methods. Thirty-two insulin resistant, premenopausal, obese women were enrolled into this clinical study. These women were treated by diet + exercise + metformin (1700 mg/d) for 6-month interval. All anthropometric characteristics, serum fasting and postprandial glucose, fasting insulin, paraoxonase, arylesterase, and malondialdehyde (MDA) levels and lipid sub-fractions were measured at the commencement and the finish of the study. Homeostasis model assessment (HOMA-IR) was used to estimate insulin resistance.
Results. Significantly reduced body weight, body mass index, waist circumference measurements, HOMA-IR and scrum fasting insulin, postprandial glucose, triglyceride, MDA levels and paraoxonase/high density lipoprotein cholesterol (HDL-C) ratio were observed at the end of the study compared with initial evaluations. Conversely, there were considerable increases in serum arylesterase and HDL-C levels following the treatment. Nevertheless, the increase in scrum PON-1 level was statistically insignificant. Arylesterase was inversely correlated with TC, LDL-C levels and HOMA-IR.
Conclusions. Met formin treatment with intensive life-style modification may be appropriate management in premenopausal, obese, insulin resistant women who have increased propensity for the development of type 2 diabetes, although long-term, controlled studies are needed for evaluation in greater detail.

• 出版日期2012-9