Effect of metformin on exercise capacity: A meta-analysis

Abstract

Aims: To evaluate the effect of metformin on various parameters of exercise capacity [oxygen consumption (VO₂), peak oxygen consumption (VO_2peak), heart rate (HR), exercise test duration, respiratory exchange ratio (RER), rating of perceived exertion (RPE), lactate and ventilatory anaerobic threshold (VAT)].

Methods: Studies reporting change in VO₂ or VO_2peak after metformin administration were included. Subgroup analyses were performed as applicable. Mean difference with 95% CIs were pooled using random-effects model [RevMan (v5.3)].

Results: There were no changes in VO₂ and VO_2peak in the overall population [VO₂: n = 388, mean difference: -0.12 ml/kg/min, 95% CI: -0.74, 0.51, p = 0.71 (i² = 0%, p = 0.99); VO_2peak: n = 345, mean difference: 0.41 ml/kg/min, 95% CI: -0.51, 1.33, p = 0.38 (i² = 0%, p = 0.89)], healthy volunteers and patients (type 2 diabetes mellitus, insulin resistance, impaired glucose tolerance/impaired fasting glucose and metabolic syndrome). For patients with insulin resistance, there was a decrease in VO_2peak, but not VO₂. In the overall population, there was a significant decrease in HR and RER, a significant increase in RPE, and no changes in exercise test duration and VAT. In addition, there was an increased VAT in the healthy volunteers.

Conclusions: In the overall population, metformin did not affect VO₂, VO_2peak, exercise test duration and VAT, although it significantly decreased HR, RER and increased RPE.

Keywords: Exercise; Metformin; Oxygen consumption; Type 2 diabetes mellitus (T2DM).