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      Actions of metformin and statins on lipid and glucose metabolism and possible benefit of combination therapy

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          Abstract

          Patients with diabetes type 2 have an increased risk for cardiovascular disease and commonly use combination therapy consisting of the anti-diabetic drug metformin and a cholesterol-lowering statin. However, both drugs act on glucose and lipid metabolism which could lead to adverse effects when used in combination as compared to monotherapy. In this review, the proposed molecular mechanisms of action of statin and metformin therapy in patients with diabetes and dyslipidemia are critically assessed, and a hypothesis for mechanisms underlying interactions between these drugs in combination therapy is developed.

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          Most cited references148

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          Polycystic Ovary Syndrome

          New England Journal of Medicine, 352(12), 1223-1236
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            Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement.

            Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States, accounting for 1 of every 3 deaths among adults.
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              Metformin action: concentrations matter.

              Metformin has been used for nearly a century and is now the most widely prescribed oral anti-diabetic agent worldwide. Yet how metformin acts remains only partially understood and controversial. One key reason may be that almost all previous studies were conducted with supra-pharmacological concentrations (doses) of metformin, 10-100 times higher than maximally achievable therapeutic concentrations found in patients with type 2 diabetes mellitus. Copyright © 2015 Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                mariel.vanstee@tno.nl
                albert.degraaf@tno.nl
                a.k.groen@amc.uva.nl
                Journal
                Cardiovasc Diabetol
                Cardiovasc Diabetol
                Cardiovascular Diabetology
                BioMed Central (London )
                1475-2840
                30 June 2018
                30 June 2018
                2018
                : 17
                : 94
                Affiliations
                [1 ]ISNI 0000 0001 0208 7216, GRID grid.4858.1, Netherlands Organisation for Applied Scientific Research (TNO), ; Zeist, The Netherlands
                [2 ]ISNI 0000000404654431, GRID grid.5650.6, Amsterdam Diabetes Center and Department of Vascular Medicine, , Academic Medical Center, ; Amsterdam, The Netherlands
                [3 ]Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
                Article
                738
                10.1186/s12933-018-0738-4
                6026339
                29960584
                2165d3e4-8af1-41b5-a330-7f3d73eafa76
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 March 2018
                : 20 June 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100011259, FP7 International Cooperation;
                Award ID: 305707
                Award Recipient :
                Categories
                Review
                Custom metadata
                © The Author(s) 2018

                Endocrinology & Diabetes
                type 2 diabetes,metformin,atorvastatin,simvastatin,combination therapy,dyslipidemia,glucose metabolism,lipid metabolism

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