Diabetes drug and exercise help reduce heart disease risk and improve body shape in HAART patients
A programme of cardiovascular and resistance exercise and use of the anti-diabetes drug metaformin resulted in significantly greater reductions in risk factors for cardiovascular disease in HAART-treated HIV-positive patients than treatment with metaformin alone, according to a US study published in the February 20th edition of AIDS. The investigators, from the Massachusetts General Hospital and the Harvard Medical School, also established that patients undertaking exercise at the same time as taking metaformin experienced an improvement in their body strength and reduction in their waist-to-hip ratio.Metformin has been shown to reduce cardiovascular risk factors and improve insulin sensitivity in HIV-positive patients who developed insulin resistance and experienced fat accumulation around the trunk after the initiation of highly active antiretroviral therapy (HAART). Disturbances in glucose levels, insulin resistance and fat redistribution have been reported in people treated with a wide range of HAART regimens. An exercise regimen consisting of both cardiovascular and resistance training has been shown to moderate many of the potential risk factors for cardiovascular disease in HAART-treated patients with lipodystrophy, including the lowering of blood pressure, a reduction in weight, a reduction in blood lipids and an improvement in waist-to-hip ratio (waist-to-hip ratio indicates the severity of central fat accumulation, which appears to increase the risk of cardiovascular disease).
The Massachusetts investigators conducted a prospective randomised study between 2000 and 2002 to see if patients with body fat redistribution and insulin resistance experienced a more effective reduction in their cardiovascular disease risk factors than individuals treated with metformin alone. A total of 37 individuals were recruited to the study. They were aged between 18 and 60 years, and all were on a stable HAART regimen. To be included in the study, it was necessary for individuals to have a fasting insulin level of above 104pmol/l and evidence of fat redistribution. After an overnight fast, the study participants had their insulin, triglycerides and cholesterol tested and tests were also conducted to read more
