二甲双胍对糖尿病视网膜病变的作用及机制

Effects of metformin on diabetic retinopathy and its mechanism

二甲双胍是国内、外推荐治疗2型糖尿病的首选一线用药,其具有良好的单药/联合治疗的疗效和安全性证据,但对糖尿病视网膜病变的作用仍然不明确。而且,至今仍缺少直接的临床证据证明二甲双胍对糖尿病视网膜病变的作用,甚至有人提出严重非增殖性和增殖性糖尿病视网膜病变是二甲双胍使用的禁忌证。近年来研究发现,二甲双胍可能通过减少视网膜损伤、减少视网膜静脉阻塞、减少视网膜新生血管形成、减轻视网膜炎性反应以及改善胰岛素抵抗等机制,延缓糖尿病视网膜病变的发生、发展,这为临床及科研人员提供了新的思路。

Metformin is the first-line drug recommended for the treatment of type 2 diabetes all over the world.It has good efficacy and safety evidence of single-agent/combination therapy,but the effect on diabetic retinopathy remains unclear.Moreover,there is still no direct clinical evidence to prove the effect of metformin on diabetic retinopathy.It has even been suggested that severe non-proliferative and proliferative diabetic retinopathy is a coutraindication for the use of metformin.In recent years,studies showed that metformin could delay the occurrence and development of diabetic retinopathy by reducing retinal damage,reducing retinal vein occlusion,reducing retinal neovascularization,reducing retinal inflammatory response, and improving insulin resistance,thus may provide new ideas for clinical and scientific researchers.