二甲双胍和非诺贝特对单纯性肥胖症患者外周胰岛素抵抗和β细胞功能的影响

Effects of metformin and fenofibrate on peripheral insulin resistance and β-cell function in patients with simple obesity

目的:观察二甲双胍和非诺贝特对单纯性肥胖症患者外周胰岛素抵抗与β细胞功能的治疗效果的影响.方法:将40例单纯性肥胖症伴高血压、高三酰甘油血症、高胰岛素血症而糖耐量正常的患者分成二甲双胍和非诺贝特治疗组及二甲双胍治疗组,治疗24wk后观察治疗前后两组患者血压、血脂、体质量指数(BMI)及胰岛素水平的变化.结果:二甲双胍和非诺贝特对伴胰岛素抵抗的高血压、高三酰甘油血症患者具有明显的降压、降脂作用,患者的BMI、空腹胰岛素水平明显下降,餐后胰岛素改变明显(P<0.05);而二甲双胍治疗组虽然血压、三酰甘油和BMI也有明显下降(P<0.05),但空腹胰岛素和餐后胰岛素的改变不及二甲双胍和非诺贝特治疗组明显(P<0.05).结论:二甲双胍和非诺贝特可增加伴胰岛素抵抗的高血压、高三酰甘油血症单纯性肥胖症患者的胰岛素敏感性,恢复β细胞功能;二甲双胍和非诺贝特联合对单纯性肥胖症患者有明显的治疗作用.

AIM： To observe the therapeutic efficacy of met formin and fenofibrate for peripheral insulin resistance and 13cell function in patients with simple obesity. METHODS： Forty cases of simple obesity with hypertension, hypertriglyceridemia, hyperinsulinemia but normal sugar tolerance were divided into the metformin and fenofibrate treatment group and the metformin treat ment group. The subjects were observed for their blood pressure, blood fat, body mass index （BMI） and insulin level before and after treatment for 24 weeks. RESULTS： Mefformin and fenofi brate could decrease blood pressure, blood fat, BMI and fasting insulin level obviously, and postmeal insulin changes were ob vious （ P 〈 0.05 ）. In mefformin treatment group, blood pressure and triglyceride, BM1 were also decreased significantly （P 〈 0.05 ） , but fasting and postmeal insulin levels did not change so notably like those in mefformin and fenofibrate treatment group （P 〈0.05）. CONCLUSION： Mefformin and fenofibrate can increase insulin sensitivity and recover 13 cell function in patients with simple obesity accompanied by insulin resistance, hyperten sion and hypertriglyeeridemia, so the combination has an obvious therapeutic action in patients with simple obesity.