2型糖尿病患者应用二甲双胍治疗前后血浆胃促生长素及YY肽水平  

Plasma ghrelin and peptide YY levels in patients with type 2 diabetes before and after metformin treatment

作　　者：吴朝明[1] 王靓[1] 金建[1] 钱掩映[1] 

机构地区：[1]温州医学院附属第二医院内分泌科,325027

出　　处：《中华内分泌代谢杂志》2011年第10期805-809,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：温州市科技计划项目（Y20100066）

摘　　要：目的观察二甲双胍治疗对新诊断2型糖尿病患者血浆胃促生长素、YY肽（PYY）水平的影响，探讨二甲双胍对2型糖尿病患者体重影响个体差异性的机制。方法采用前瞻性巢式病例对照研究作为研究设计方案。64例新诊断2型糖尿病患者应用二甲双胍治疗12周，根据治疗后体重的变化情况，分为体重减轻组及体重未减轻组，治疗前后测定空腹血浆胃促生长素、PYY水平及相关代谢指标。结果2型糖尿病患者经二甲双胍治疗后空腹血浆胃促生长素水平均较治疗前明显下降[（10．71±2．68对11．81±3．19）rig／ml，P〈O．05]，空腹血浆PYY水平均较治疗前明显升高[（136．86±39．14对128．42±37．31）pg／ml，P〈O．05]。治疗后有43．7％的2型糖尿病患者出现体重明显下降。体重减轻组在治疗后空腹血浆胃促生长素水平下降16．6％，降幅高于体重未减轻组的6．2％（P〈O．05）；体重减轻组在治疗后空腹血浆PYY水平升高10．8％，升幅高于体重未减轻组的3．5％（P〈O．05）。结论2型糖尿病患者二甲双胍治疗后体重明显减轻者较体重基本保持不变者，空腹血浆胃促生长素水平降低更显著，空腹血浆PYY水平升高更显著，具体机制还有待进一步研究。Objective To investigate the effects of metformin on plasma ghrelin and peptide YY （ PYY ） levels in newly-diagnosed type 2 diabetic patients, and to study the impact of mefformin on body weight. Methods A prospective nested case-control study was designed as a research protocol. Sixty four newly-diagnosed type 2 diabetic patients were treated with metformin for 12 weeks. The patients were divided into two groups： weight loss group and non-weight loss group according to the changes in body weight after metformin treatment. Fasting plasma ghrelin and PYY levels and other metabolic parameters were measured before and after metformin treatment. Results Fasting plasma ghrelin level was significantly decreased in the patients after metformin treatment [ （ 10.71±2.68 vs 11. 81 ± 3.19） ng/ml,P〈0. 05 ]. Fasting plasma PYY level was significantly increased in patients after metformin treatment [ （ 136.86±39.14 vs 128.42±37.31 ） pg/ml ,P〈0. 05 ]. After metformin treatment, 43.7% of the patients lost body weight significantly. Fasting plasnla ghrelin level was decreased by 16. 6% after treatment in the weight loss group, as compared with 6. 2% in non weight loss group （ P〈0. 05 ）. Fasting plasma PYY level was increased by 10. 8% after treatment in the weight loss group, as compared with 3.5% in the non-weight loss group （P 〈 0.05 ） . Conclusions The fasting plasma ghrelin level in the weight loss group was lowered more significantly compared with that in the non-weight loss group after mefformin treatment. The fasting plasma PYY level in the weight loss group was elevated more significantly as compared with that in the non-weight loss group after metformin treatment. The mechanism remains to be further studied.

关 键 词：二甲双胍 糖尿病 2型 体重指数 胃促生长素 YY肽 

分 类 号：R587.1[医药卫生—内分泌]