medwireNews: An analysis of data from the Diabetes Prevention Program suggests that taking metformin may help to limit coronary atherosclerosis in patients with prediabetes – but only in men.
The researchers found no evidence of an influence of menopausal status to explain the lack of an effect in women, and although their atherosclerosis measure, coronary artery calcium (CAC), was less severe in women than men, it was still present in just over half of the female study participants, suggesting any effect should have been detectable.
“This raises the possibility of hormonal interactions,” say Ronald Goldberg (The George Washington University Biostatistics Center, Rockville, Maryland, USA) and study co-authors, noting that metformin reportedly reduces testosterone levels in men but not in women.
The study participants included 643 men and 1418 women, who were aged around 50 years and had prediabetes. After an average 13.7 years of follow-up, the prevalence of CAC was 75% in men randomly assigned to receive metformin, significantly lower than the 84% and 85%, respectively, among those in the placebo and lifestyle-management groups. Likewise, age-adjusted CAC severity was 39.5 Agatston units versus 66.9 and 58.3 Agatston units.
The beneficial effect of metformin on CAC was limited to men without severe CAC (score<100), the team notes in Circulation.
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