COMMENTARY

Metformin and Growth Rate of Abdominal Aortic Aneurysms

Albert B. Lowenfels, MD

Disclosures

November 16, 2017

Does metformin reduce the rate of growth of abdominal aortic aneurysms (AAAs)? In a paper published in the British Journal of Surgery,[1] the authors studied 1697 patients with an AAA where growth rate was determined either by ultrasound, CT scan, or by a Philips Medical Systems imaging workstation. The follow-up interval ranged from 1 to 3.6 years.

In all three imaging groups, the 173 patients prescribed metformin were more likely to have significantly slower growth rates than other patients, even when adjusted for the initial size of the AAA, sex, heart disease, and smoking (P = .007-.029).

Viewpoint

On a global basis, AAA disease is a major health problem responsible for about 20 million deaths each year. It is associated with age, implying that death rates will increase over time. This report[1] and several other similar studies[2,3] imply that metformin, one of the commonest drugs used to treat diabetes, could significantly slow the growth rate of AAA disease.

There is some biologic support of this concept because metformin may limit inflammation and reduce oxidative stress. Metformin has been shown to reduce the growth rate of experimental AAA disease. As suggested by the authors, the data from this and other reports justify a randomized trial to clarify the role of metformin in the control of AAA disease.[4]

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