Advances in Clinical and Experimental Medicine
2017, vol. 26, nr 4, July, p. 671–677
doi: 10.17219/acem/63025
PubMed ID: 28691423
Publication type: original article
Language: English
Download citation:
The magnitude of weight loss induced by metformin is independently associated with BMI at baseline in newly diagnosed type 2 diabetes: Post-hoc analysis from data of a phase IV open-labeled trial
1 Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China
Abstract
Background. The impact of metformin on body weight is variable in T2DM patients among studies. The reasons for the discrepancies are still unknown.
Objectives. We aimed to find out the possible predictive factors of weight change induced by metformin based on an analysis of a phase IV open-labeled trial.
Material and Methods. We performed a sub-analysis from a prospective, multi-center phase IV open-labeled study in which 371 Chinese newly-diagnosed type 2 diabetes patients received 16 weeks’ extended-release metformin monotherapy. The clinical characteristics including weight and laboratory assessments of subjects were collected every 4 weeks. The weight changes from baseline to week 4, 8, 12 and 16 were calculated respectively. The patients were divided into 4 groups by quartile statistics method according to magnitudes of weight change.
Results. Of 371 enrolled patients, 324 patients had the weight records from baseline to week 16. The weight decreased gradually with each visit (p < 0.001) and the average weight loss was 2 kg after 16 weeks’ treatment of metformin. The patients with higher BMI and bigger waist circumference at baseline showed a more pronounced weight loss. However, the magnitudes of weight loss were independently associated with BMI at baseline only.
Conclusion. Metformin can lead to weight loss gradually in newly-diagnosed type 2 diabetes patients. The magnitude of weight loss was independently and only associated with baseline BMI.
Key words
obesity, weight loss, metformin, Asia diabetes
References (24)
- Currie CJ, Poole CD, Gale EA. The influence of glucose-lowering therapies on cancer risk in type 2 diabetes. Diabetologia. 2009;52:1766–1777.
- Mahmood K, Naeem M, Rahimnajjad NA. Metformin: The hidden chronicles of a magic drug. Eur J Intern Med. 2013;24:20–26.
- Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998;352:854–865.
- Scarpello JH, Howlett HC. Metformin therapy and clinical uses. Diabetes & vascular disease research. Official Journal of the International Society of Diabetes and Vascular Disease. 2008;5:157–167.
- Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycaemia in type 2 diabetes, 2015: A patient-centred approach. Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia. 2015;58:429-442.
- Ji L, Li H, Guo X, Li Y, Hu R, Zhu Z. Impact of baseline BMI on glycemic control and weight change with metformin monotherapy in Chinese type 2 diabetes patients: phase IV open-label trial. PloS One. 2013;8:e57222.
- Ji L, Newman J, Lu J, Cai X. Understanding the standard of care in the treatment of type 2 diabetes in China: Results from a national survey. Chinese Medical Journal. 2014;27:3524–3529.
- Meraviglia P, Angeli E, Del Sorbo F, et al. Risk factors for indinavir-related renal colic in HIV patients: predictive value of indinavir dose/body mass index. Aids. 2002;16:2089–2093.
- Mather KJ, Verma S, Anderson TJ. Improved endothelial function with metformin in type 2 diabetes mellitus. Journal of the American College of Cardiology. 2001;37:1344–1350.
- Saenz A, Fernandez-Esteban I, Mataix A, Ausejo M, Roque M, Moher D. Metformin monotherapy for type 2 diabetes mellitus. The Cochrane Database of Systematic Reviews. 2005,CD002966.
- Ito H, Ishida H, Takeuchi Y, Antoku S, Abe M, Mifune M, Togane M. Long-term effect of metformin on blood glucose control in non-obese patients with type 2 diabetes mellitus. Nutrition & Metabolism. 2010;7:83.
- Stumvoll M, Nurjhan N, Perriello G, Dailey G, Gerich JE. Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. The New England Journal of Medicine. 1995;33:550–554.
- Ong CR, Molyneaux LM, Constantino MI, Twigg SM, Yue DK. Long-term efficacy of metformin therapy in nonobese individuals with type 2 diabetes. Diabetes Care. 2006;29:2361–2364.
- Fontbonne A, Diouf I, Baccara-Dinet M, Eschwege E, Charles MA. Effects of 1-year treatment with metformin on metabolic and cardiovascular risk factors in non-diabetic upper-body obese subjects with mild glucose anomalies: A post-hoc analysis of the BIGPRO1 trial. Diabetes & Metabolism. 2009;35:385–391.
- Seifarth C, Schehler B, Schneider HJ. Effectiveness of metformin on weight loss in non-diabetic individuals with obesity. Experimental and clinical endocrinology & diabetes: Official journal, German Society of Endocrinology [and] German Diabetes Association. 2013;121:27–31.
- Malin SK, Nightingale J, Choi SE, Chipkin SR, Braun B. Metformin modifies the exercise training effects on risk factors for cardiovascular disease in impaired glucose tolerant adults. Obesity. 2013;21:93–100.
- Diabetes Prevention Program Research G. Long-term safety, tolerability, and weight loss associated with metformin in the Diabetes Prevention Program Outcomes Study. Diabetes Care. 2012;35:731–737.
- Yang W, Liu J, Shan Z, et al. Acarbose compared with metformin as initial therapy in patients with newly diagnosed type 2 diabetes: an open-label, non-inferiority randomised trial. The Lancet Diabetes & Endocrinology. 2014;2:46–55.
- Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycaemia in type 2 diabetes: A patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2012;55:1577–1596.
- Socolovsky M, Paez MD. A literature review of intercostal-to-musculocutaneous-nerve transfers in brachial plexus injury patients: Does body mass index influence results in Eastern versus Western countries? Surgical Neurology International. 2013;4:152.
- Obesity: Preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization technical report series 2000;894;i-xii:1–253.
- Zhou BF, Cooperative Meta-Analysis Group of the Working Group on Obesity in C. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomedical and environmental sciences. BES. 2002;15:83–96.
- Malin SK, Kashyap SR. Effects of metformin on weight loss: Potential mechanisms. Current Opinion in Endocrinology, Diabetes, and Obesity. 2014;21:323–329.
- Look ARG, Wadden TA, West DS, et al. The Look AHEAD study: A description of the lifestyle intervention and the evidence supporting it. Obesity. 2006;14:737–752.