Metformin and Dietary Restriction to Prevent Age-related Morbid Events in People With Metabolic Syndrome

Study Overview
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Brief Summary
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Phase III randomized controlled trial on men and women with Metabolic syndrome (MetS) to test the hypothesis that comprehensive life-style changes and/or metformin treatment prevent age-related chronic non-communicable diseases (ArCD). The aim of the present study is to evaluate the effect of a comprehensive life-style intervention (including moderate physical activity and Mediterranean/macrobiotic diet with moderate calorie and protein restriction), and of treatment with Metformin (a calorie restriction mimetic drug) for the prevention of ArCD.

Detailed Description
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Phase III randomized controlled trial on men and women with MetS to test the hypothesis that comprehensive life-style changes and/or metformin treatment prevent ArCD. Design: 2x2 factorial: 2,000 volunteers will be randomized in four equal groups of 500 each, and allocated to the following treatments: METFORMIN (1700MG/DAY) + ACTIVE LIFESTYLE INTERVENTION PLACEBO + ACTIVE LIFESTYLE INTERVENTION METFORMIN (1700 mg/day) alone PLACEBO alone The metformin /placebo component of the study will be double blind.

Official Title
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Randomized Controlled Trial of Metformin and Dietary Restriction to Prevent Age-related Morbid Events in People With Metabolic Syndrome

Conditions
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Metabolic Syndrome

Intervention / Treatment
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* Drug: Metformin Hydrochloride 850 MG Oral Tablet [Glucophage]
* Drug: Ludipress, mg stereate, micronized hydrated silica, talcum


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 55-74, waist circumference equal or greater than 85 cm for women and 100 cm for men, plus at least two other factors among those defining the MetS Exclusion Criteria: Diagnosed diabetes (or baseline fasting glycemia above 7mmol/L at baseline examination) Cancer (except skin carcinoma) diagnosed in the last 5 years, or under treatment Excessive frailty: in absence of agreed-upon measurements parameters and cutoff points, the investigator will exclude subjects under the lower 5th percentile of the muscular mass distribution estimated by impedance in previous studies Conditions that contraindicate the use of MET because might favour lactic acidosis: Renal, cardiac, hepatic, or respiratory insufficiency Serum creatinine <124μmol/L, or proteinuria at baseline examination Current treatment with K-sparing diuretics, or with proton pump inhibitors Excessive alcohol consumption Distressing side effects of MET treatment. Nausea and diarrhoea typically occur in about one third of patients receiving MET for the first time at full dose. To avoid dropouts for gastrointestinal discomfort we will treat all volunteers with half the planned dose for one month in order to exclude intolerant subjects before randomization. Participants randomized in the intervention group will continue to take half a dose for one month and then shift to the full dose.

Ages Eligible for Study
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Minimum Age: 55 Years
Maximum Age: 74 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: METFORMIN (1700MG/DAY) + LIFESTYLE<br>METFORMIN: 2 tablets per day, one at breakfast (or lunch) and one at dinner, of either metformin (two 850 mg tablets/day) + participation in the life-style intervention activities | Drug: Metformin Hydrochloride 850 MG Oral Tablet [Glucophage]<br> <br> |
| Placebo Comparator: PLACEBO+ LIFESTYLE<br>Placebo: (two identical tablets) according to the blind assignment + participation in the life-style intervention activities | Drug: Ludipress, mg stereate, micronized hydrated silica, talcum<br>* Tablet<br>|
| Experimental: METFORMIN (1700 mg/day) alone<br>METFORMIN: 2 tablets per day, one at breakfast (or lunch) and one at dinner, of either metformin (two 850 mg tablets/day) | Drug: Metformin Hydrochloride 850 MG Oral Tablet [Glucophage]<br> <br> |
| Placebo Comparator: PLACEBO alone<br>Placebo: (two identical tablets) according to the blind assignment | Drug: Ludipress, mg stereate, micronized hydrated silica, talcum<br>* Tablet<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total incidence of age related chronic diseases | We will retrieve records for all Age related chronic diseases but we will first concentrate the analysis on cancer, coronary heart disease, stroke, and diabetes | 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect of the intervention on total mortality and on the incidence of specific chronic diseases. | The measure is a composite outcome measure consisting of multiple measures (results to be reported as a single value for each Arm/Group). The outcome measure describes multiple assessments with potentially different Units of Measure as indicated: Waist circumference: cm Glycemia: mg/dL Blood pressure: mmHg Total cholesterol, HDL cholesterol: mg/dL Triglycerides: mg/dL | 8-10 years |