二甲双胍对2型糖尿病患者血浆内皮素的影响

Effects of metformin treatment on plasma endothelin in type 2 diabetes mellitus patients

目的 研究二甲双胍治疗对2 型糖尿病患者血浆内皮素(ET)、胰岛素敏感性指数(IAI)等的影响。方法 将2型糖尿病患者随机分为二甲双胍治疗组和磺脲类治疗组,并与正常对照组比较,糖尿病患者分别于治疗前和治疗后4 周测定空腹血糖(FPG)、餐后2 h血糖(P2hPG)、空腹胰岛素(FINS)、餐后2 h胰岛素(P2hINS)、ET、总胆固醇(TC)、三酰甘油(TG)及体重指数(BMI)。结果 2型糖尿病患者的血浆FPG、P2hPG、FINS、P2hINS TC、TG、ET水平均显著高于正常对照组(P<0.01)。二甲双胍治疗组治疗4 周后FPG、P2hPG、FINS、P2hINS、TC、TG、ET水平均较治疗前显著降低(P<0.01或0.05),IAI则明显增高(P<0.05)。磺脲类治疗组治疗4周后除FPG、P2hPG明显降低外(P<0.01和0.05),其他指标均无显著变化(P>0.05)。结论 二甲双胍能增加IAI、显著改善内皮功能、降低ET,因而有助于延缓糖尿病并发症的发生和发展。

Objective To investigate the effects of metformin on plasma endothelin and insulin in type 2 diabetes mellitus.Methods 68 cases of type 2 DM were randomly divided into Metformin group and sulfonylurea group,comparing with healthy control group. FPG, plasma ET, INS, TC, TG and BMI were determined before and after the treatment.Results The plasma ET、INS were significantly higher in type 2 DM than those in healthy controls(P< 0.01). After treatment for 4 weeks, FPG, FINS, ET, TC, TG were significantly reduced in the Metformin group(P< 0.01). IAI was increased in the metformin group(P< 0.05). There were little changes in the above items except FPG, P2hPG in the sulfonylureas group.Conclusions Metformin can increase the insulin sensitivity and decrease plasma endothelin; with delaying the development of complications.