Affiliation:
1. Research Institute of Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics; Novosibirsk State Medical University
2. Research Institute of Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
Abstract
Aim. To study the effect of extended-release (XR) metformin on humoral cardiometabolic markers and lipid peroxidation parameters in patients with heart failure with preserved ejection fraction (HFpEF), prediabetes and abdominal obesity (AO).Material and methods. The study included 64 people (men – 50%, median age – 58 [55,25; 59,75] years) with HFpEF, prediabetes and AO. All patients (groups A and B) received optimal therapy for HFpEF. In group A (n=32), metformin XR 1000-1500 mg/day was additionally prescribed. A general clinical examination was carried out, determining the level of soluble interleukin 33 receptor (sST2), N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP), the initial level of malondialdehyde (MDA) in low-density lipoproteins (LDL) and their resistance to oxidation with copper ions initially and after 6 months.Results. In group A, a decrease in NT-proBNP by 3,7% (p <0,001) was recorded. In group B, NT-proBNP values increased by 2,7% (p=0,013) compared to baseline levels. The decrease in NT-proBNP in the metformin group was accompanied by a decrease in hsCRP levels by 31% (p<0,001). No changes in sST2 concentration were demonstrated in either group. The level of MDA in LDL after 6-month metformin therapy became lower by 20% (p=0,002) relative to the initial value. When assessing the resistance to LDL oxidation with copper ions, the MDA content did not differ from the initial value. In group B, the initial MDA content in LDL increased by 3,7% (p=0,002) and after incubation with copper ions increased by 31,8% (p<0,001).Conclusion. In patients with prediabetes, HFpEF and AO, 6-month metformin XR + optimal HFpEF therapy was associated with a decrease in NT-proBNP, as well as the severity of oxidative stress in the form of a decrease in the concentration of MDA in LDL and the serum level of hsCRP.