IMC Journal of Medical Science
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Ibrahim Medical College Journal of Medical ScienceTahmina AkterMd. Reza Bin ZaidZeenat Farzana RahmanM Abu Sayeed https://www.imcjms.com/registration/journal_full_text/91
2016-09-26 09:36:36Original ArticleIMC J Med Sci 2016; 10(1): 18-23
0.05
Knee
(n=30 )
Control (n=6)
16.66
83.34
Drug (n=24 )
37.50
62.50
>0.05
Knuckle (n=27 )
Control (n=7)
00.00
100.00
Drug (n=20 )
25.00
75.00
>0.05
Table-3: Improvement
of AN in different sites following metformin treatment as determined by
quantitative scale of measuring AN
This
study demonstrates that metformin therapy for AN with IR has a significant
beneficial effect and is also safe and well tolerated. Improvement was assessed
by reduction of score as measured by the quantitative scaling method scale [18]
and vice versa. The study also reveals that metformin has different clinical effects
on AN in different anatomic location. It seems that its effect is more pronounced
in AN affecting axilla and neck. It could be due to the presence of more insulin-like
growth factor 1 receptors in these specific sites. But further specific study
is needed to elucidate its mechanism in these sites.
Correcting
hyperinsulinemia was presumably accomplished by metformin and led to
improvement or resolution of AN. Oral metformin hydrochloride is a first choice
drug in the treatment of AN associated to obesity and IR [1]. Metformin does
not induce hypoglycemia but prevents hyperglycemia. In IR, hyperinsulinemia
precedes type 2 diabetes mellitus sometimes by many years. AN develops during
this non-diabetic hyperinsulinemic period. Thus, recognition of AN identifies
those at increased risk of developing type 2 diabetes mellitus, dyslipidemia
and hypertension. Therefore, recognition of AN offers an opportunity for both
preventive measures and focused intervention.
The
present study had some limitations. The sample size was small and the long-term
effects of metformin on the outcome of AN could not be assessed. The diagnostic
and scoring criteria used in the study was based solely on direct visual
examination. No histopathological scoring or grading technique of AN was
available. Study was precisely directed to AN associated with biochemical
evidence of IR and AN due to other causes was not included.
This
research was funded by Aristopharma Ltd. We express our acknowledgement to Dr.
Shahidul Alam Khan, PhD, Chief Research Officer and Head, Dept. of
Endocrinology and Immunology, BIRDEM, for overall guidance and support for
performing laboratory works; Dr. Md. Zahid Hasan, Associate Prof. Dept of
Physiology and Molecular Biology, BIRDEM, for his valuable opinion regarding
the laboratory methods. We are also grateful to Dr. Anisur Rahman, Dr. Lipika
and colleagues and staffs of Dermatology department of BIRDEM General Hospital
for supporting and referring patients.
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