| Objective: Our study aimed to observe the effects of metformin on the body mass index, fat mass, waist circumference, fasting serum glucose, insulin, HOMA-IR, MCP-1 and visfatin levels of simple obese patients, and to discuss the possible mechanisms of their effects, so as to assess the impacts of metformin on obesity-related inflammatory state and cardiovascular risk factors and provide clinical evidence for pharmacotherapy of obesity.Methods: 31 simple obese patients including 13 men and 18 women were recruited as obesity group. 30 subjects including 11 men and 19 women without clinical evidence of major diseases were recruited from an unselected population that underwent routine medical check-up and were used as the control group. 19 of these 31 obese patients were treated with metformin (1500mg/d ) for twelve weeks. Body composition and fasting blood sample for every subject were collected, the fasting serum MCP-1 and visfatin levels were measured by EIA , insulin was detected by RIA.Results: (1) The body mass index (BMI), waist circumference, fat%, fat mass and basic metabolic rate (BMR) of simple obese patients were markedly higher than those of control subjects (P<0.01). The diastolic blood pressure of obesity group is also higher than that of control group, but not for systolic blood pressure. There were no significant difference for fat free mass and total body water between obese patients and control subjects.(2) The fasting serum triglyceride levels of simple obese patients was significantly higher than that of normal subjects (P<0.01), but not for total choles-terol(TC)(P =0.76), high-desity lipoprotein cholesterol (HDL-c) (P =0.31) and low-density lipoprotein cholesterol(LDL-c) (P =0.61). The fasting insulin level(P<0.01), HOMA-IR (P<0.01) and serum MCP-1 concentration(P<0.05) of obesity group were markedly higher than those of control group. While the level of serum visfatin in obese patients was markedly lower than that of controls(P<0.05). There was no significant difference for fasting serum glucose between obese patients and control subjects (P = 0.35).(3) Metformin decreased the BMI and waist circumference of obese subjects(P<0.05), but the fat%(P=0.72), fat mass(P = 0.35) and BMR(P = 0.33) didn't be changed significantly after 12 weeks treatment with metformin.(4) Metformin significantly decreased the serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), TC, LDL-c and fasting serum glucose of obese subjects (P<0.05). Serum MCP-1 level of obese subjects was also markedly decreased by metformin (P<0.01), but serum visfatin concentration was significantly increased after treatment with metformin (P<0.01). The serum triglyceride, HDL-c, uric acid, insulin and HOMA-IR were slightly decreased, the change had no statistical significance.(5) Circulating MCP-1 correlated significantly with both BMI(r = 0.326, P<0.05) and waist circumference(r = 0.344, P<0.05). Serum visfatin level was found to correlate significantly with waist circumference(r = -0.296, P<0.05).Conclusions: The fasting serum MCP-1 levels in simple obese subjects are markedly higher than in normal subjects. Serum visfatin concentrations of obese subjects are lower than those of normal controls. Metformin may decrease obese subject's weight, waist circumference and serum MCP-1 level, this means that metformin may be helpful to improve the state of insulin resistence and decrease the occurrence of cardiovascular diseases in obese subjects. The serum visfatin concentration of obese subject is increased afer treatment with metformin, there may be a relation between visfatin and the improvement of insulin sensitivity.
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