二甲双胍和罗格列酮对单纯性肥胖症患者胰岛素抵抗和β细胞功能的影响

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

目的观察二甲双胍和罗格列酮对单纯性肥胖症患者胰岛素抵抗与β细胞功能的治疗效果。方法将40例单纯性肥胖症伴高血压、高甘油三酯血症、高胰岛素血症而糖耐量正常的患者分成二甲双胍和罗格列酮联合治疗组(治疗组)和二甲双胍治疗组(对照组),治疗6月,观察治疗前后患者血压、血脂、体重指数(BMI)及胰岛素水平变化。结果二甲双胍和罗格列酮对伴胰岛素抵抗的高血压、高甘油三酯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,服糖后胰岛素也改变明显(P<0.05);而二甲双胍治疗组虽然血压、甘油三酯和BMI也有所下降(P<0.05),但空腹胰岛素和服糖后胰岛素改变不及二甲双胍和罗格列酮联合治疗组明显(P<0.05)。结论二甲双胍和罗格列酮可增加伴胰岛素抵抗的高血压、高甘油三酯血症的单纯性肥胖症患者的胰岛素敏感性,恢复β细胞功能;二甲双胍和罗格列酮联合对单纯性肥胖症患者有明显的治疗作用。

Objective To observe the therapeutic efficacy of metformin and rosiglitazone for insulin resistance and β-cell function in patients With simple obesity. Methods Forty cases of simple obesity with hypertension, hypertriglyceridemia, hyperinsulinemia but normal sugar tolerance were divided into metformin and rosiglitazone treatment group and metformin treatment group, and then cured for 6 months and observed for their blood pressure, blood fat, body mass index （BMD and insulin level before and after treatment. Results Metformin and rosiglitazone could decrease blood pressure, blood fat, body mass index （BMI） and fasting insulin level obviously, and post-meal insulin changes were obvious （P 〈 0. 05）. In metformin treatment group , blood pressure and triglyceride and BMI were also decreased significantly （P 〈 0.05）, but fasting and post-meal insulin level did not change so notably as those in metformin and rosiglitazone treatment group （P〈0.05）. Conclusion Metformin and rosiglitazone can increase insulin sensitivity and recover β-cell function in patients with simple obesity accompanied by insulin resistance, hypertension and hypertriglyceridemia, so the combination has an obvious therapeutic action in patients with simple obesity.