Studies in the recent past have shown the role of metformin in ameliorating metabolic disorder by inducing fibroblast growth factor 21 in adipose tissue. Some researches supported that brown adipose tissue may be a target of metformin. Furthermore, they suggested that metformin may affect energy metabolism in adipose tissue, and improve endoplasmic reticulum stress in white adipose tissue.¹

A qualitative analysis of available literature performed recently focused on randomized clinical trials to evaluate the link between administration of metformin and adipokine regulation in people with metabolic syndrome. The major electronic databases such as MEDLINE, Cochrane Library, Scopus, and EMBASE were searched for eligible randomized controlled trials. Overall, 13 such trials met the inclusion criteria, with a total of 4,605 participants. Subjects with metabolic syndrome were characterized by a state of obesity, impaired glucose tolerance, insulin resistance, and type 2 diabetes.²

Accumulating evidence from these trials showed the blood glucose lowering effects of metformin. Moreover, they indicated its efficacy in promoting weight loss, ameliorating insulin resistance, and reducing pro-inflammatory markers such as tumor necrosis factor-alpha and interleukin-6 in patients with metabolic syndrome. It is noteworthy that these therapeutic effects are related to upregulation of adiponectin and suppression of leptin and resistin.²

References

1. Yuan T, Li J, Zhao W, et al. Effects of metformin on metabolism of white and brown adipose tissue in obese C57BL/6J mice. Diabetol Metab Syndr. 2019;11:96.
2. Dludla PV, Nkambule BB, Mazibuko-Mbeje SE, et al. Adipokines as a therapeutic target by metformin to improve metabolic function: A systematic review of randomized controlled trials. Pharmacol Res. 2020 Oct 2;105219.