二甲双胍对2型糖尿病患者肠道内双歧杆菌含量的影响

Effect of metformin on intestinal bifidobacterium content in patients with type 2 diabetes mellitus

目的探讨二甲双胍对2型糖尿病患者肠道内双歧杆菌含量的影响。方法选取2019年1月1日至2021年1月1日期间西安市人民医院内分泌与代谢疾病中心收治的106例2型糖尿病为研究对象,采用随机数字法将其分为对照组和观察组各53例。观察组患者口服盐酸二甲双胍肠溶片治疗,对照组患者采用安慰剂治疗。两组患者治疗2周后,采用葡萄糖耐量试验测定血清空腹血糖(FPG)、餐后2 h血糖(2 hPG)及糖化血红蛋白A1c(HbA1c)水平;采用放射免疫法测定空腹胰岛素(FINS)水平,以稳态模型评价胰岛β细胞功能指数(HOMA-β)及胰岛素抵抗指数(HOMA-IR);采用光冈法测定粪便中双歧杆菌含量。结果治疗后,观察组患者的FPG、2 hPG及HbA1c水平分别为(8.56±1.81)mmol/L、(12.09±1.96)mmol/L、(9.12±1.75)%,明显低于治疗前及对照组的(9.36±2.09)mmol/L、(13.18±2.40)mmol/L及(10.13±2.88)%,差异均有统计学意义(P<0.05);治疗后,观察组患者的HOMA-β为42.78±9.09,明显高于治疗前及对照组的39.35±8.17,HOMA-IR为3.82±1.23,明显低于治疗前及对照组的4.55±1.62,差异均有统计学意义(P<0.05);治疗后,观察组患者的肠道双歧杆菌含量为(8.56±3.11)logN/g,明显高于其治疗前及对照组的(7.33±2.50)logN/g,差异均有统计学意义(P<0.05)。结论二甲双胍可有效控制2型糖尿病患者血糖水平,提高肠道内双歧杆菌含量可能是其作用机制之一。

Objective To investigate the effect of metformin on intestinal bifidobacterium content in patients with type 2 diabetes mellitus.Methods A total of 106 patients with type 2 diabetes mellitus admitted to the Center for Endocrine and Metabolic Diseases,Xi'an People's Hospital from January 1,2019 to January 1,2021 were selected.The patients were divided into a control group and an observation group,with 53 patients in each group.The patients in the observation group was treated with metformin hydrochloride enteric-coated tablets,while the patients in the control group was treated with placebo.After 2 weeks of treatment,the fasting blood glucose(FPG),2-hour postprandial blood glucose(2 hPG),and glycosylated hemoglobin A1c(HbA1c)levels were delected by glucose tolerance test.The levels of fasting insulin(FINS)were delected by radioimmunoassay.βcell function index(HOMA-β)and insulin resistance index(HOMA-IR)were evaluated by steady-state model,and the content of bifidobacterium in feces was determined by the method of Mitsuoka.Results After treatment,the levels of FPG,2 hPG,and HbA1c in the observation group were(8.56±1.81)mmol/L,(12.09±1.96)mmol/L and(9.12±1.75)%,respectively,which were significantly lower than those before treatment and(9.36±2.09)mmol/L,(13.18±2.40)mmol/L,and(10.13±2.88)%in the control group(P<0.05).After treatment,HOMA-βin the observation group was 42.78±9.09,which was significantly higher than that before treatment and 39.35±8.17 in the control group;and the HOMA-IR was 3.82±1.23,significantly lower than that before treatment and 4.55±1.62 in the control group(P<0.05).After treatment,the content of intestinal bifidobacteria in the observation group was(8.56±3.11)logN/g,which was significantly higher than that before treatment and(7.33±2.50)logN/g in the control group(P<0.05).Conclusion Metformin can effectively control the blood sugar level of patients with type 2 diabetes,and increasing the content of bifidobacteria in the intestine may be one of its mechanisms.