二甲双胍对妊娠期糖尿病患者外周血内皮祖细胞及氧化应激水平的影响

Influence of metformin on peripheral blood endothelial progenitor cells and oxidative stress levels in patients with gestational diabetes mellitus

目的 探究二甲双胍对妊娠期糖尿病(gestational diabetes mellitus,GDM)患者外周血内皮祖细胞(endothelial progenitor cells,EPCs)及氧化应激水平的影响。方法 选取收治的98例GDM患者,随机分为对照组(n=49)和观察组(n=49),对照组给予常规干预和门冬胰岛素治疗,观察组在对照组治疗的基础上给予二甲双胍辅助治疗。比较2组的血糖水平[空腹血糖(fasting blood-glucose,FBG)、餐后2小时血糖(2-hour postprandial blood glucose,2 hPG)和糖化血红蛋白(glycosylated hemoglobin,HbA1c)]、胰岛素抵抗和胰岛素水平[胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HO-MA-IR)、空腹胰岛素(fasting insulin,FINS)和饭后1 h胰岛素(insulin 1 h after meal,1 h INS)]、外周血EPCs百分比和数量以及氧化应激水平[谷胱甘肽(glutathione,GSH)、超氧化物歧化酶(superoxide dismutase,SOD)和丙二醛(malonaldehyde,MDA)]。结果 治疗后,与对照组比较,观察组的FBG、2 hPG、HbA1c、FINS、1 hINS、HO-MA-IR和MDA均明显较低(P<0.05),外周血EPCs数量和百分比、GSH和SOD均明显较高(P<0.05)。结论 针对GDM患者,在常规干预和门冬胰岛素治疗的基础上给予二甲双胍辅助治疗可更好地控制血糖水平,改善胰岛素抵抗和胰岛素水平,提高外周血EPCs的增殖能力,下调机体氧化应激水平。

Objective To investigate the influence of metformin on peripheral blood endothelial progenitor cells(EPCs)and oxidative stress levels in patients with gestational diabetes mellitus(GDM).Methods A total of 98 GDM patients were selected and randomly divided into control group(n=49)and observation group(n=49).The control group was given routine intervention and insulin aspart treatment,while the observation group received metformin adjuvant therapy on the basis of the control group.The blood glucose levels[fasting blood glucose(FBG),2-hour postprandial blood glucose(2 hPG),and glycosylated hemoglobin(HbA1c)],insulin resistance and insulin levels[homeostasis model assessment of insulin resistance(HO-MA-IR),fasting insulin(FINS),and 1 hour postprandial insulin(1 h INS)],the percentage and number of peripheral blood EPCs,oxidative stress levels[glutathione(GSH),superoxide dismutase(SOD),and malondialdehyde(MDA)]were compared between the 2 groups.Results After treatment,compared with the control group,the FBG,2 hPG,HbA1c,FINS,1 h INS,HO-MA-IR and MDA in the observation group were significantly lower(P<0.05),while the number and percentage of peripheral blood EPCs,GSH,SOD were significantly higher(P<0.05).Conclusion For GDM patients,adjuvant metformin therapy on the basis of routine intervention and insulin aspart therapy can control blood glucose,improve insulin resistance and insulin levels,increase the proliferation ability of peripheral blood EPCs,and down-regulate oxidative stress levels.