SIRT1 and cardiovascular disorder: Thus, further long-term studies in a larger population of obese patients with pre-diabetic condition will be needed to confirm our findings and to determine if the metformin-induced abdominal fat regulation of SIRT1 and of cytokine blood levels added to abdominoplastic surgery and hypocaloric diet could be translated into a reduced incidence of cardiovascular disease in patients with pre-diabetic condition.