Ann Pediatr Endocrinol Metab.  2019 Sep;24(3):187-194. 10.6065/apem.2019.24.3.187.

Association of metformin and statin medications with surrogate measures of cardiovascular disease in youth with type 1 diabetes: the SEARCH for diabetes in youth study

• Gourgari E
• Stafford J
• D'Agostino R
• Dolan LM
• Lawrence J
• Mottl A
• Pihoker C
• Urbina EM
• Wadwa RP
• Dabelea D

• KMID: 2460766
• DOI: http://doi.org/10.6065/apem.2019.24.3.187

Abstract

PURPOSE
Youth with type 1 diabetes mellitus (T1DM) are at risk of cardiovascular disease (CVD). We evaluated if metformin or statin use was associated with surrogate measures of improved CVD.
METHODS
We included participants from the SEARCH observational study. Participants treated with insulin plus metformin (n=42) or insulin plus statin (n=39) were matched with 84 and 78 participants, respectively, treated with insulin alone. Measures of arterial stiffness obtained were pulse wave velocity (PWV), augmentation index (AI75), and heart rate variability as standard deviation of the normal-to-normal interval (SDNN) and root mean square differences of successive NN intervals (RMSSD).
RESULTS
CVD measures were not significantly different among participants on insulin plus metformin versus those on insulin alone: PWV (5.9±1.0 m/sec vs. 5.8±1.5 m/sec, P=0.730), AI75 (1.8 [-6.0 to 8.0] vs. -2.4 [-10.7 to 3.8], P=0.157), SDNN (52.4 [36.8-71.1] m/sec vs. 51.8 [40.1-74.9] m/sec, P=0.592), and RMSSD (43.2 [29.4-67.6] vs. 47.4 [28.0-76.3], P=0.952). CVD measures were not different for statin users versus nonusers: PWV (5.7±0.8 m/sec vs. 5.9 ±1.1 m/sec, P=0.184), AI75 ( -4.0 [-9.5 to 1.7] vs. -6.7 [-11.3 to 5.7], P=0.998), SDNN (54.6 [43.5-77.2] m/sec vs. 63.1 [44.2-86.6] m/sec, P=0.369), and RMSSD (49.5 [31.2-74.8] vs. 59.2 [38.3-86.3], P=0.430).
CONCLUSION
We found no associations of statin or metformin use with surrogate measures of CVD. Future prospective pediatric clinical trials could address this issue.

Keyword

Metformin; Type 1 diabetes; Adolescents; Statin; Cardiovascular disease

MeSH Terms

Adolescent*
Cardiovascular Diseases*
Diabetes Mellitus, Type 1
Heart Rate
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors*
Insulin
Metformin*
Morinda
Observational Study
Prospective Studies
Pulse Wave Analysis
Vascular Stiffness
Insulin
Metformin

Reference

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