SAT-550 - Association of Medication Use with Metabolic Outcomes in Individuals with METS

Introduction: Multiple medications are associated with metabolic effects, including changes in weight, lipids, and glucose. Concurrent use of medications with metabolic effects may impact response to lifestyle intervention for metabolic syndrome (MetS). This study evaluated the association of baseline use of potentially-interfering medications (pIMs) on anthropometric and metabolic changes at 6 months for individuals with MetS.

Methods: The study used baseline and 6-month data on medication use, weight, waist circumference (WC), physical activity (daily steps) and metabolic characteristics (blood pressure, lipids, and glucose) from participants enrolled in the Enhancing Lifestyles in Metabolic Syndrome (ELM) lifestyle intervention trial. Eligible participants could not be enrolled in a weight loss program at baseline, had MetS, and did not have diabetes nor take any other diabetes medications except metformin. Body mass index (BMI), body roundness index (BRI) and MetS Severity Index were calculated. pIMs include any medication classes affecting weight, glucose and lipid levels. ANOVA and Chi-square tests assessed differences at baseline. Difference in outcomes from baseline to 6 months were assessed using multivariable linear regression model, adjusting for age, race, ethnicity, employment status, daily steps at baseline and intervention.

Results: Out of the total 528 participants included in this study, 471 (78%) were taking at least one of the pIMs (Range 1-8). At baseline, pIMed users were significantly older, White, non-Hispanic, and were more likely to be employed or retired. pIMed users were significantly less likely to be active, with an average of 4.208 steps compared to 5066 steps among non-pMI users (p = < 0.001) and more likely to meet all the MetS criteria except for lipid criteria. Gabapentin use was associated with lower reduction in MetS severity index (β= 0.2; p= 0.042) and glucose levels (β= 6.2; p= 0.015). Beta-blocker users had a lower reduction in BMI (β= 0.6; p= 0.024) and larger reduction HDL levels (β= -1.9; p= 0.018). Metformin use was associated with significantly larger reduction in WC (β= -2.4; p=0.021) and BRI (β= -0.4; p=0.021). Sex hormone (estrogens and progesterone) use was associated with 25.2 mg/dl lesser decrease in triglyceride levels (p= 0.32).

Conclusions: Prescription medication use was common among the study participants with MetS and had significant association with their 6-month outcomes. Metformin use augmented reduction in central obesity by reducing WC, but use of gabapentin, beta-blockers or sex hormones was associated with poorer response in metabolic outcomes. These findings highlight the influence of commonly used medications on cardio-metabolic outcomes, and the importance of accounting for their effects when evaluating the effectiveness of lifestyle interventions.

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