Insulin resistance as a therapeutic target for improved endothelial function: Metformin

Lori Brame, Subodh Verma, Todd Anderson, Amale Lteif, Kieren Mather

Research output: Contribution to journalReview article

11 Scopus citations


Endothelial dysfunction is a feature of a variety of clinical states of insulin resistance, and increasingly it is recognized that pre-diabetic states of insulin resistance are associated not only with insulin resistance but with increased cardiovascular risk. The metabolic syndrome which typically accompanies insulin resistance brings aberrations in a number of classical cardiovascular risk factors, but it appears that insulin resistance itself represents an additional, non-classical risk factor. Therefore, the approach to treating the endothelium in patients with the metabolic syndrome might include therapies targeting insulin resistance. In this review, we provide a detailed overview of the current state of knowledge regarding the biguanide metformin and its effects on the endothelium. Its mode of action is reviewed, along with the available data from laboratory and experimental studies related to vascular function in animals and in humans. Metformin has beneficial effects on endothelial function which appear to be mediated through its effects to improve insulin resistance. Therapeutically targeting insulin resistance appears to be a viable route to improving endothelial function in clinical states of insulin resistance.

Original languageEnglish (US)
Pages (from-to)53-63
Number of pages11
JournalCurrent Drug Targets - Cardiovascular and Haematological Disorders
Issue number1
StatePublished - Mar 1 2004


  • Endothelin
  • Endothelium
  • Insulin
  • Insulin resistance
  • Metabolic syndrome
  • Metformin

ASJC Scopus subject areas

  • Molecular Medicine
  • Cardiology and Cardiovascular Medicine
  • Hematology
  • Pharmacology

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