二甲双胍对骨代谢的影响

Effects of metformin on bone metabolism

二甲双胍(metformin)是2型糖尿病患者的一线用药,在50余年的临床应用中,已显示出安全、有效、全面控制血糖的效果。近年越来越多的研究发现,二甲双胍促进体外成骨细胞的增殖、分化及细胞外基质矿化,逆转高浓度葡萄糖对成骨细胞功能的损伤,抑制破骨细胞的形成;动物研究进一步证实二甲双胍增加鼠的骨矿含量以及松质骨容量,促进新骨形成,促进正常血糖大鼠及糖尿病大鼠的骨损伤修复;临床研究也发现二甲双胍影响糖尿病患者骨密度,但其对骨代谢的影响以及机制尚未完全阐明。本文综述了二甲双胍对骨代谢的影响,并探讨其可能的作用机制。

Metformin [- 1-（ diaminomethyli- dene）-3,3-dimethylguani-dine] is an antihyper glycemia drug commonly used for the manage- ment of type 2 diabetes, which has been widely used for more than fifty years and had safety, valid and full-scale effects on controlling plasma glucose in patients with diabetes mellitus. Re cent years, more and more studies found that metformin induced osteoblastic growth and dif- ferentiation, increased the mineralization of the extracellular matrix, reversed the deleterious effects of high glucose on osteoblast function and also inhibited osteoclastogenesis; Furthermore, in vivo, treatment of mice with metformin has been found to increase bone mineral content, trabecular bone volume and induce bone forma-tion. In addition, using a model of minimal bone defect metformin treatment stimulated bone reossification in both control and diabetic rats. Furthermore, in clinical research, metformin in fluenced bone mineral density in patients with diabetes mellitus. However, the effects of met formin on bone metabolism and the molecular mechanisms for the action of metformin are still unclear. This article reviews the effects of met formin on bone metabolism and discusses its possible mechanisms.