Abstract With an increasing prevalence of metabolic syndrome (MS) early detection and timely management of cardiometabolic risk factors are crucial to prevent complications such as type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). There are no defined treatments for MS apart from addressing each of its components such as insulin resistance, hyperinsulinaemia, obesity, dyslipidaemia, hypertension and hyperglycaemia. The mechanism responsible for diabetes prevention is related to improved insulin sensitivity and reduced hyperinsulinaemia. Metformin has been established as a first-line therapy in patients with T2DM because it counteracts hyperinsulinaemia and hyperglycaemia and reduces cardiometabolic risk. Although the cardiovascular benefits with metformin are clearly demonstrated in diabetic and prediabetic patients, the efficacy of metformin in reducing cardiometabolic risk factors in persons with MS and normal glucose tolerance (NGT) remains inconclusive. This review focuses on the evidence base considering the therapeutic potential of metformin in NGT persons with MS representing a high-risk population for development of T2DM and CVD.

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二甲双胍对正常糖耐量代谢综合征患者的治疗潜力

摘要 随着代谢综合征 (MS) 患病率的增加，及早发现和及时管理心脏代谢危险因素对于预防 2 型糖尿病 (T2DM) 和心血管疾病 (CVD) 等并发症至关重要。除了解决其各个组成部分（例如胰岛素抵抗、高胰岛素血症、肥胖症、血脂异常、高血压和高血糖症）之外，还没有明确的 MS 治疗方法。预防糖尿病的机制与改善胰岛素敏感性和减少高胰岛素血症有关。二甲双胍已被确定为 T2DM 患者的一线治疗，因为它可以抵消高胰岛素血症和高血糖症并降低心脏代谢风险。尽管二甲双胍对心血管的益处在糖尿病和糖尿病前期患者中得到了明确证明，二甲双胍在降低多发性硬化症和正常糖耐量 (NGT) 患者心脏代谢危险因素方面的功效仍无定论。本综述侧重于考虑二甲双胍在 NGT 患者中的治疗潜力的证据基础，MS 患者是 T2DM 和 CVD 发展的高危人群。