Effect of Pre-Meal Metformin With or Without an Acute Exercise Bout on Postprandial Lipemic and Glycemic Responses in Metabolic Syndrome Patients: A Randomized, Open Label, Crossover Study

by Selleckchem | Mar 12 2023

Introduction: Both exercise and pre-meal metformin could lower postprandial glucose and lipid profiles.

Aims: To explore whether pre-meal metformin administration is superior to metformin administration with the meal in reducing postprandial lipid and glucose metabolism, and whether its combination with exercise confer superior benefits in metabolic syndrome patients.

Materials and methods: In a randomized crossover design, 15 metabolic syndrome patients were assigned to 6 sequences including 3 experimental conditions: metformin administration with a test meal (met-meal), metformin administration 30 min prior to a test meal (pre-meal-met) with or without an exercise bout designed to expend 700 Kcal at 60% VO2 peak performed the evening just before pre-meal-met condition. Only 13 participants (3 males, 10 females; age: 46 ± 9.86, HbA1c: 6.23 ± 0.36) were included in the final analysis.

Results: Postprandial triglyceridemia was unaffected by any condition (all P > .05). However, both pre-meal-met (-7.1%, P = .009) and pre-meal-metx (-8.2%, P = .013) significantly reduced total cholesterol AUC with no significant differences between the two latter condition (P = .616). Similarly, LDL-cholesterol levels were significantly lower during both pre-meal-met (-10.1%, P = .013) and pre-meal-metx (-10.7%, P = .021) compared to met-meal with no difference between latter conditions (P = .822). Plasma glucose AUC was significantly reduced by pre-meal-metx compared to both pre-meal-met (-7.5%, P = .045) and met-meal (-8%, P = .03). Insulin AUC was significantly lower during pre-meal-metx compared to met-meal (-36.4%, P = .044).

Conclusions: Metformin administration 30 minutes prior to meal seems to exert favorable effects on postprandial TC and LDL-Cholesterol levels compared to its administration with meal. Addition of one exercise bout only improved postprandial glycemia and insulinemia.

Comments：

In this study, the researchers aimed to investigate the effects of pre-meal metformin administration compared to metformin administration with the meal on postprandial lipid and glucose metabolism in metabolic syndrome patients. Additionally, they wanted to determine whether the combination of pre-meal metformin with exercise would confer superior benefits.

The study used a randomized crossover design, and 15 metabolic syndrome patients were assigned to six sequences including three experimental conditions: metformin administration with a test meal (met-meal), metformin administration 30 min prior to a test meal (pre-meal-met) with or without an exercise bout designed to expend 700 Kcal at 60% VO2 peak performed the evening just before pre-meal-met condition. Thirteen participants were included in the final analysis.

The results showed that postprandial triglyceridemia was not affected by any condition. However, both pre-meal-met and pre-meal-metx significantly reduced total cholesterol AUC with no significant differences between the two latter conditions. Similarly, LDL-cholesterol levels were significantly lower during both pre-meal-met and pre-meal-metx compared to met-meal with no difference between latter conditions. Plasma glucose AUC was significantly reduced by pre-meal-metx compared to both pre-meal-met and met-meal. Insulin AUC was significantly lower during pre-meal-metx compared to met-meal.

In conclusion, pre-meal metformin administration 30 minutes prior to the meal seems to have favorable effects on postprandial total cholesterol and LDL-cholesterol levels compared to its administration with the meal. The addition of one exercise bout only improved postprandial glycemia and insulinemia.