Abstract 18491: Metformin Lowers Circulating Adiponectin Levels in Patients with Myocardial Infarction
Introduction: Adiponectin is an adipokine and its levels are reduced in obesity, diabetes, and prevalent heart disease. However, the association of adiponectin and CV disease is complex, and studies have reported contradictory results with respect to the relation between adiponectin and CV disease. Furthermore, the oral antidiabetic agent, metformin, has multiple effects on metabolic parameters and is associated with better clinical outcomes compared to other antidiabetic agents. This study sought to determine the effects of metformin on adiponectin levels in patients with myocardial infarction (MI).
Methods: The GIPS-III trial was a randomized, double-blind, placebo-controlled study conducted in 380 patients who underwent primary percutaneous coronary intervention (PCI) for a first time MI. The aim was to evaluate the efficacy of 4 months metformin treatment on preserving left ventricular function post-MI in non-diabetic patients. From 308 patients (mean age 58 ± 11 years, 78.9% male), both baseline and 4 month samples were available for plasma adiponectin measurement.
Results: Placebo and metformin groups were well-matched, and metformin treatment had no effect on plasma glucose levels. Median baseline adiponectin level was 5057 ng/ml (IQR: 3325-7596) and median adiponectin level after 4 months was 4643 (IQR: 2768-6867). We observed a significant lowering of adiponectin levels following 4 months of metformin treatment compared to placebo (-629 versus -166, respectively; P=0.026). Baseline adiponectin levels were further assessed and divided into quartiles (Q1: 67 - 3297; Q2: 3352 - 5051; Q3: 5064 - 7549; Q4: 7643 -20118). Increasing adiponectin levels were associated with increased age (P=0.02), gender (higher in females, P<0.001), lower BMI (P=0.01), elevated heart rate (P=0.03), as well as higher N-terminal pro-B-type natriuretic peptide levels both at baseline (P<0.001) and at 4 months (P<0.001).
Conclusions: In this study, we show that treatment with metformin lowers circulating adiponectin levels. Metformin has been associated with improved CV outcomes, and the lowering of adiponectin may explain, at least in part, the cardioprotective effects of metformin.
Author Disclosures: M.V. Cannon: None. C.P. Lexis: None. A. Rogier van der Velde: None. I.C. van der Horst: None. E. Lipsic: None. M.M. Dokter: None. D.J. van Veldhuisen: None. P. van der Harst: None. R.A. de Boer: None.
- © 2014 by American Heart Association, Inc.