{"publication_id":"36aaf125-4dd8-45d1-aa0a-b78668a65f06","content_hash":"sha256:376a7ab8cd2939d7049fb3a3a2bce5f78411f7f8b8d941e4bfa49eabad0fe5a4","nodes":[{"id":"36aaf125-4dd8-45d1-aa0a-b78668a65f06","type":"publication","title":"EX-MET Program: Endpoint-Specific Metformin and Exercise Findings"},{"id":"claim_1","type":"claim","text":"10.1111/dom.70478 - EX-MET companion analysis; randomized trial in human; endpoint: metabolic insulin sensitivity and insulin-stimulated carbohydrate oxidation; direction: attenuated. Source title: Metformin attenuates metabolic insulin sensitivity and insulin-stimulated carbohydrate oxidation after high-intensity exercise training in adults at risk for metabolic syndrome."},{"id":"claim_2","type":"claim","text":"10.1111/jch.70215 - EX-MET companion analysis; randomized trial in human; endpoint: exercise training induced blood pressure and aortic waveform adaptations; direction: altered. Source title: Metformin Alters Exercise Training Induced Blood Pressure and Aortic Waveform Adaptations in Adults at Risk for Metabolic Syndrome."},{"id":"claim_3","type":"claim","text":"Receipts 10.1111/dom.70478, 10.3390/ijerph17103695, and 10.1111/jch.70215 are companion analyses from the same EX-MET trial program; they form one evidence unit, not independent replications."},{"id":"claim_4","type":"claim","text":"1. 10.1111/dom.70478 Metformin attenuates metabolic insulin sensitivity and insulin-stimulated carbohydrate oxidation after high-intensity exercise training in adults at risk for metabolic syndrome., 2026, Diabetes, obesity & metabolism. Source: fullraw:pubmed. ID: https://doi.org/10.1111/dom.70478"},{"id":"claim_5","type":"claim","text":"3. 10.1111/jch.70215 Metformin Alters Exercise Training Induced Blood Pressure and Aortic Waveform Adaptations in Adults at Risk for Metabolic Syndrome., 2026, Journal of clinical hypertension (Greenwich, Conn.). Source: fullraw:pubmed. ID: https://doi.org/10.1111/jch.70215"},{"id":"source_1","type":"source","study":"Metformin attenuates metabolic insulin sensitivity and insulin-stimulated carbohydrate oxidation after high-intensity exercise training in adults at risk for metabolic syndrome.","year":2026,"doi":"10.1111/dom.70478","url":"https://doi.org/10.1111/dom.70478","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary","excerpt":"Mixed evidence exists on whether metformin adds to or attenuates the insulin-sensitising effects of exercise. To date, no studies have tested whether metformin differentially impacts exercise training intensity-mediated insulin sensitivity. We tested the hypothesis that metformin would blunt metabolic insulin sensitivity and carbohydrate oxidation in an intensity-based manner among adults with metabolic syndrome (MetS) risk. In a double-blind, placebo-controlled trial, participants were randomised to low-intensity exercise plus placebo (~55% VO HiEx + PL increased metabolic insulin sensitivity (p = 0.017) while HiEx + Met, LoEx + PL, or LoEx + Met did not. HiEx + PL also raised insulin-stimulated carbohydrate oxidation and decreased fat oxidation compared with LoEx + Met (both, p = 0.008). Increased metabolic insulin sensitivity related to reductions in fasting glucose (r = -0.41, p = 0.025), VO Metformin attenuated metabolic insulin sensitivity and insulin-stimulated carbohydrate oxidation after high-intensity exercise training in adults at risk for MetS."},{"id":"source_2","type":"source","study":"Optimizing the Interaction of Exercise Volume and Metformin to Induce a Clinically Significant Reduction in Metabolic Syndrome Severity: A Randomised Trial.","year":2020,"doi":"10.3390/ijerph17103695","url":"https://doi.org/10.3390/ijerph17103695","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary","excerpt":"Insulin resistance is a central mediating factor of the metabolic syndrome (MetS), with exercise training and metformin proven antidotes to insulin resistance. However, when the two therapies are combined there is conflicting data regarding whether metformin blunts or improves exercise training-induced adaptations. The volume of exercise (duration, intensity, and frequency) on the interaction of exercise training and metformin has yet to be investigated. The aim of this study is therefore to explore the impact of a combination of different exercise volumes and metformin on MetS severity. This is a secondary analysis of data from one of the sites of the 'Exercise in Prevention of Metabolic Syndrome' (EX-MET) study. Ninety-nine adults with MetS were randomized into a 16-week exercise program completing either: (i) moderate-intensity continuous training (MICT) at 60-70% of peak heart rate (HRpeak) for 30 min/session ("},{"id":"source_3","type":"source","study":"Metformin Alters Exercise Training Induced Blood Pressure and Aortic Waveform Adaptations in Adults at Risk for Metabolic Syndrome.","year":2026,"doi":"10.1111/jch.70215","url":"https://doi.org/10.1111/jch.70215","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary","excerpt":"Metformin reduces hyperglycemia and cardiovascular disease risk. However, no study has determined if metformin alters blood pressure and/or aortic waveforms in an exercise intensity dependent manner. We tested if metformin alters blood pressure and aortic waveforms before and during insulin-stimulation following low and high intensity exercise training. In a double-blind, placebo controlled trial, participants were randomized to low intensity exercise plus placebo (∼55% VO"}],"edges":[{"from":"36aaf125-4dd8-45d1-aa0a-b78668a65f06","to":"claim_1","type":"contains_claim"},{"from":"36aaf125-4dd8-45d1-aa0a-b78668a65f06","to":"claim_2","type":"contains_claim"},{"from":"36aaf125-4dd8-45d1-aa0a-b78668a65f06","to":"claim_3","type":"contains_claim"},{"from":"36aaf125-4dd8-45d1-aa0a-b78668a65f06","to":"claim_4","type":"contains_claim"},{"from":"36aaf125-4dd8-45d1-aa0a-b78668a65f06","to":"claim_5","type":"contains_claim"}],"screening":{"identified":3,"screened":3,"excluded":0,"included":3,"included_or_retained":3,"flow":["identified","screened","excluded_with_reasons","included"],"wording":"3 candidate receipts retained after source retrieval, deduplication, and topic filtering. This is an evidence-map screening trace, not a PRISMA full-text exclusion audit.","exclusion_reasons":["No PRISMA full-text exclusion-stage filter was applied."]}}