盐酸二甲双胍对糖耐量减低者血清抵抗素水平的影响

Influence of Metformin on the serum resistin concentration in patients with impaired glucose tolerance

目的:探讨盐酸二甲双胍对糖耐量减低者(IGT)血清抵抗素水平影响作用。方法:选取我院门诊就诊的IGT患者96例,随机分为两组,对照组(饮食控制和运动治疗)48例,治疗组(饮食控制和运动治疗+二甲双胍)48例,分别于干预治疗0周、12周及24周,检测血糖、血清胰岛素、糖化血红蛋白(HbA1c)、血清抵抗素水平等以及体质量指数(BMI,kg/m2)等指标,比较干预治疗前后上述指标的变化。结果:①在随访研究过程中,其中7例因不良反应或违反方案退出研究,共89例(对照组45例和治疗组44例)完成24周临床观察并纳入统计分析。②与干预治疗前相比,对照组和治疗组的BMI、空腹血糖(FBG)、餐后2 h血糖(PBG)、收缩压(SBP)、空腹胰岛素(FINS)、餐后2 h胰岛素(PINS)、HOMA胰岛素抵抗指数(HOMA-IR)、血三酰甘油(TG)和总胆固醇(TC)等水平,在干预治疗24周后均明显下降且差异有统计学意义(P<0.05);与对照组相比,干预治疗24周后治疗组的BMI、FBG、PBG、FINS、PINS和HOMA-IR等水平均明显降低,且两组间比较差异有统计学意义(P<0.05)。③与干预治疗前相比,治疗组血清抵抗素水平在干预治疗24周后明显下降且差异有高度统计学意义(P<0.001),而且明显低于对照组(P<0.01);经校正BMI和HbA1c后,差异仍有统计学意义(P<0.05)。而对照组血清抵抗素水平在干预治疗24周后有所下降,但差异无统计学意义(P=0.063)。结论:盐酸二甲双胍可以明显降低IGT者血清抵抗素水平,且这种作用不完全依赖于体重的减少和血糖的下降。

Objective：To investigate the influence of Metformin on the serum resistin concentration in patients with impaired glucose tolerance（IGT）.Methods：96 cases of IGT were randomly divided into two groups：control group（treated with diet control and exercise） 48 cases and treatment group（treated with diet and exercise ＋Metformin） 48 cases.In intervention therapy for 0,12 and 24 weeks,the indexes of glucose,serum insulin,glycosylated hemoglobin（HbA1c）,serum resistin levels and body mass index（BMI） were detected respectively.Results：① In the follow-up study process,7 cases were withdrew from the study due to adverse reactions or violate the plan,a total of 89 patients（45 cases in the control group and 44 cases in treatment group） had completed clinical observation of 24 weeks and were incorporated into statistical analysis.② After intervention treatment of 24 weeks,the BMI,fasting plasma glucose（FBG）,2 hours postprandial blood glucose（PBG）,systolic blood pressure（SBP）,fasting insulin（FINS）,2 hours postprandial insulin（PINS）,HOMA insulin resistance index（HOMA-IR）,serum triglyceride（TG） and total cholesterol（TC） levels in the control group and the treatment group were all significantly decreased,and the differences between before and after intervention treatment were statistically significant（P〈0.05）;compared with the control group,the BMI,FBG,PBG,FINS,PINS and HOMA-IR level in the treatment group decreased significantly after intervention therapy for 24 weeks,and the differences between the two groups were statistically significant（P〈0.05）.③ After the intervention treatment of 24 weeks,the serum resistin level in the treatment group was significantly decreased（P〈0.001）,and was lower than that in the control group（P〈0.01）;after adjusting for BMI and HbA1c,these differences were still statistically significant（P〈0.05）.While there was no statistically significant difference of serum resistin level in the control group before and after intervention treatment of 24 weeks（P=0.063）.Conclusion：This study indicates that Metformin can reduce the serum resistin levels in subjects with IGT,and this action is not entirely dependent on weight reduction and decline of glucose concentration.