二甲双胍对米氮平所致体质量增加抑郁症患者肝脏脂肪含量及糖脂代谢的影响

Effects of Metformin on Liver Fat Content and Glucose and Lipid Metabolism in Depressive Disorder Patients with Mirtazapine-Induced Weight Gain

目的探讨二甲双胍对米氮平所致体质量增加抑郁症患者肝脏脂肪含量及糖脂代谢的影响。方法选择100例米氮平所致体质量增加(≥7%)的抑郁症患者,按随机数字法分为对照组和观察组,每组各50例。对照组采用米氮平联合安慰剂治疗,观察组采用米氮平联合二甲双胍治疗,疗程16周。比较2组患者治疗前后的肝脏脂肪含量、糖代谢指数[体质指数(BMI)、空腹血糖(FBG)、餐后2h血糖(2hPBG)]和脂代谢指数[总胆固醇(TC)、三酰甘油(TAG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)]。结果治疗16周后,观察组患者肝脏脂肪含量、各糖代谢指数及TC、TAG、LDL明显低于对照组,HDL高于对照组(均P<0.05)。结论二甲双胍对米氮平所致体质量增加抑郁症患者肝脏脂肪含量及糖脂代谢具有一定的影响,可以降低肝脏脂肪含量,改善糖脂代谢指数。

Objective To investigate the effects of metformin on liver fat content and glucose and lipid metabolism in depressive disorder patients with mirtazapine-induced weight gain.Methods One hundred depressive disorder patients with mirtazapine-induced weight gain（≥7%）were randomly treated for 16 weeks with mirtazapine in combination with either placebo（control group,n=50）or metformin（observation group,n=50）.The liver fat content,body mass index（BMI）,fasting blood glucose（FBG）,2hpostprandial blood glucose（2hPBG）,total cholesterol（TC）,triacylglyceol（TAG）,high density lipoprotein（HDL）and low density lipoprotein（LDL）were measured before and after treatment.Results Compared with control group,the liver fat content,BMI and levels of FBG,2hPBG,TC,TAG and LDL decreased and the levels of HDL increased in observation group after treatment for 16weeks（P〈0.05）.Conclusion Metformin can reduce liver fat content and improve glucose and lipid metabolism in depressive disorder patients with mirtazapine-induced weight gain.