Dynamics of lipid and carbohydrate metabolism parameters in women with menopausal metabolic syndrome, receiving glucose-lowering therapy

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Aim. To assess the tolerability and the impact of various glucose-lowering medications on carbohydrate and lipid profile and anthropometric parameters in women with menopausal metabolic syndrome (MMS). Material and methods. The baseline examination included 122 women in early postmenopause. Thirty three patients with MS, carbohydrate metabolism disturbances, and/or insulin resistance (IR) were included in the 12-week open comparative study. Group I (n=15) received acarbose (150 mg/d) for 12 weeks, while Group II (n=18) was administered metformin (850 mg/d) for 12 weeks. At baseline and 12 weeks later, anthropometry, oral glucose tolerance test with insulin and C-peptide level measurement, and lipid profile assessment were performed. Results. Acarbose therapy was associated with a reduction in body weight (BW), body mass index (BMI), waist circumference (WC), fasting insulin, post-load insulin, post-load C-peptide, and HOMA-IR index. However, no significant improvement in lipid metabolism parameters was observed in the acarbose group. Metformin treatment was linked to a significant reduction in BW, WC, glycated hemoglobin, post-load glucose, C-peptide, and insulin, as well as to an increase in post-load Caro index. Conclusion. Women with MMS, carbohydrate metabolism disturbances, and/or IR, require not only non-pharmaceutical lifestyle modification, but also glucose-lowering pharmaceutical therapy with acarbose or metformin. In particular, it should be considered that metformin, but not acarbose, reduces the levels of total cholesterol and triglycerides.