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Title: Cardiac syndrome X, insulin resistance and microvascular dysfunction : the use of metformin in a double-blind randomised controlled trial
Author: Jadhav, Sachin
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
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I performed a randomised double-blinded placebo-controlled trial in which women with cardiac ‘Syndrome X’ were compared with a healthy control group to examine differences in their metabolic measures, anthropometric measures and peripheral microvascular function. I went on to administer metformin or placebo for 8 weeks to women with cardiac ‘Syndrome X’. The recruitment protocol and methods used are described in chapter 3. The differences between women with cardiac ‘Syndrome X’ and healthy controls are discussed in chapter 4. I show that after correction for age and body mass index, there exists significant differences between the groups in terms of indices of insulin resistance, some lipid parameters, some serum markers of endothelial function and serum leptin. The process of laser Doppler imaging in conjunction with iontophoretically-applied acetyl-choline and sodium nitroprusside is used to assess peripheral microvascular function, and this is discussed in chapter 5. In particular, the reproducibility of these measurements both between arms, and several weeks apart is validated. I go on to show that there is a significant difference both in the endothelium-dependent and independent peripheral microvascular vasodilating response, between women with cardiac ‘Syndrome X’ and controls, in chapter 6. I demonstrate in chapter 7 that administration of metformin to women with cardiac ‘Syndrome X’ results in significant improvement in some indices of insulin resistance, some lipid measures, some serum markers of endothelial function and body mass. Furthermore, in chapter 8, improvement in endothelium-dependent microvascular function and in some ischaemic-measures is shown following metformin administration. Finally, the potential use of these techniques in clinical practice is discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available