July - September 2012, Volume 8, Issue 3

Fenkci SM, Karagenc N, Fenkci V

An Open Pilot Atudy to Evaluate the Effects of Metformin and Life Style Changes on Serum Paraoxonase Activity and Oxidative Stress Markers in Premenopausal, Obese, Insulin Resistant Women

Acta Endo (Buc) 2012, 8 (3): 403-412
doi: 10.4183/aeb.2012.403

Background. The prevention of type 2 diabetes has great clinical importance. Many pharmacologic and nonpharmacologic\r\nmethods are used to prevent type 2 DM. Metformin reduces the risk of developing diabetes in insulin resistant subjects. Oxidative stress plays pivotal roles in the pathogenesis and complications of diabetes mellitus. Paraoxonase 1 has\r\nantioxidant capacity.\r\nObjective. This study was planned to assess the effects of metformin and life style changes on paraoxonase activity and\r\noxidative stress markers in premenopausal, obese, insulin resistant women.\r\nDesign.Open-pilot clinical study.\r\nSubjects and methods. Thirty-two insulin resistant, premenopausal, obese women were enrolled into this clinical\r\nstudy. These women were treated by diet + exercise + metformin (1700 mg/d) for 6-month interval. All anthropometric characteristics, serum fasting and\r\npostprandial glucose, fasting insulin, paraoxonase, arylesterase, and malondialdehyde (MDA) levels and lipid\r\nsub-fractions were measured at the commencement and the finish of the study. Homeostasis model assessment (HOMAIR)\r\nwas used to estimate insulin resistance.\r\nResults. Significantly reduced body weight, body mass index, waist circumference measurements, HOMA-IR and serum fasting\r\ninsulin, postprandial glucose, triglyceride, MDA levels and paraoxonase/high density lipoprotein cholesterol (HDL-C) ratio were observed at the end of the study compared\r\nwith initial evaluations. Conversely, there were considerable increases in serum arylesterase and HDL-C levels following the treatment. Nevertheless, the increase in serum PON-1 level was statistically insignificant.\r\nArylesterase was inversely correlated with TC, LDL-C levels and HOMA-IR.\r\nConclusions. Metformin treatment with intensive life-style modification may be appropriate management in premenopausal,\r\nobese, insulin resistant women who have increased propensity for the development of type 2 diabetes, although long-term,\r\ncontrolled studies are needed for evaluation in greater detail.

Keywords: paraoxonase, metformin, oxidative stress, insulin resistance, obesity

Correspondence: Fenkci Semin Denizli State Hospital - Department of Internal Medicine, Division of Endocrinology and Metabolism, Saraylar M. Doktorlar C. Denizli Devlet Hastanesi\r\nDenizli 20100, Turkey