二甲双胍对初诊2型糖尿病患者纤溶酶原激活物抑制物1水平的影响

Effect of metformin on plasminogen activator inhibitor-1 in newly diagnosed type 2 diabetic patients

目的观察二甲双胍对初诊2型糖尿病(T2DM)患者纤溶酶原激活物抑制物1(PAI-1)水平的影响。方法选择2013年10月至2016年11月安徽省铜陵市人民医院的初诊T_2DM患者95例,按照随机数字表法分为二甲双胍组(48例)和阿卡波糖组(47例);选择同期体检中心健康体检者48例为对照组。二甲双胍组口服二甲双胍治疗12周;阿卡波糖组口服阿卡波糖治疗12周。测定受试者空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)和PAI-1水平,T2DM患者治疗后复查上述指标。结果治疗前二甲双胍组和阿卡波糖组的空腹血糖、餐后2 h血糖、HbA1c和PAI-1水平均明显高于对照组(均P<0.05),但2组间各指标差异无统计学意义(P>0.05)。经治疗后,二甲双胍组空腹血糖、餐后2 h血糖、HbA1c及PAI-1水平均较治疗前明显下降[(6.5±0.7)mmol/L比(8.5±0.8)mmol/L、(9.9±1.2)mmol/L比(12.9±1.4)mmol/L、(6.2±0.5)%比(7.7±0.6)%、(38±8)μg/L比(50±9)μg/L](P<0.01);阿卡波糖组空腹血糖、餐后2 h血糖及HbA1c水平较治疗前明显下降[(6.6±0.8)mmol/L比(8.3±0.9)mmol/L、(9.8±1.3)mmol/L比(13.1±1.6)mmol/L、(6.2±0.5)%比(7.6±0.5)%](P<0.01),PAI-1水平变化差异无统计学意义[(47±8)μg/L比(48±8)μg/L](P>0.05)。治疗后二甲双胍组PAI-1水平明显低于阿卡波糖组,差异有统计学意义(P<0.01)。结论二甲双胍治疗初诊T_2DM患者可降低患者体内的PAI-1水平,该作用独立于其降血糖作用。

Objective To investigate the effect of metformin on plasminogen activator inhibitor-1 （PAI-1） in patients with newly diagnosed type 2 diabetes mellitus （T2 DM）. Methods A total of 95 patients with newly diagnosed T2DM admitted in Tongling People＇s Hospital in Anhui Province from October 2013 to November 2016 were randomly divided into metformin group （48 cases） and acarbose group （47 cases） ; 48 healthy people were enrolled from medical examination center as control group. Fasting plasma glucose（ FPG）, postprandial 2 h plasma glucose（2 h PG）, glycosylated hemoglobin（HbAlc） and PAI-1 were tested before and after 12 weeks of metformin or acarbose treatment. Results Baseline levels of FPG, 2 h PG, HbAlc and PAI-1 in diabetic patients were significantly higher than those in control group （ P 〈 0. 05 ） ; there were no significant differences of the indexes between metformin group and acarbose group （ P 〉 0. 05 ）. After treatment, levels of FPG,.2 h PG, HbA1 c and PAI-1 in metformin group significantly decreased compared to those before treatment [ （6. 5 ± 0.7 ）mmol/L vs （8.5 ±0. 8）mmol/L, （9.9± 1.2）mmol/L vs （12.9± 1.4）mmol/L, （6.2±0.5）% vs （7.7 ±0. 6）% , （38 ± 8）μg/L vs （50±9）μg/L] （P 〈0.01）; levels of FPG, 2 h PG and HbAlc in acarbose group significantly decreased compared to those before treatment[ （6. 6 ±0. 8） mmol/L vs （8. 3 ±0. 9） mmol/L, （9. 8± 1.3） mmol/L vs （13.1±1.6）mmol/L, （6.2±0.5）% vs （7.6±0.5）%]（P〈0.01）; the level of PAI-1 in aearbose group showed no significant difference compared to that before treatment[ （47 ±8 ） μg/L vs （48 ±8 ） μg/L] （P 〉 0.05 ）. The level of PAI-1 in metformin group after treatment was significantly lower than that in acarbose group （ P 〈 0. 01 ）. Conclusion Mefformin treating newly diagnosed T2DM can effectively reduce PAI-1 level, which is independent of its hypoglyeemie effect.