不同体质指数对于老年2型糖尿病患者服用二甲双胍胃肠道不良反应的影响  

Different body mass index and gastrointestinal side effects of metformin in elderly people with type 2 diabetes

作　　者：蒋翠萍[1] 黄宇新[1] 孙皎[1] 

机构地区：[1]复旦大学附属华东医院内分泌科,上海市200040

出　　处：《老年医学与保健》2016年第1期44-47,共4页Geriatrics & Health Care

摘　　要：目的已知二甲双胍最常见的不良反应是胃肠道症状,但其影响因素尚不明确。探讨不同体质指数对老年2型糖尿病患者服用二甲双胍耐受性的影响。方法本研究入组257例老年2型糖尿病患者,根据BMI分为体重正常组、超重组和肥胖组,起始给予二甲双胍500mg/d治疗,观察4周,所有受试者二甲双胍剂量从500mg/d逐步增加至1 500mg/d,观察评估各组间胃肠道不良反应情况。结果共257例老年2型糖尿病患者,其中体重正常组100例,(72.6±7.7)岁,超重组107例,(70.2±7.0)岁,肥胖组50例,(71.1±8.0)岁。基线情况下3组胃肠道不良症状发生率无差异。服用二甲双胍后,超重组及肥胖组的胃肠道不良反应发生率(腹胀及纳差)较正常组少(P<0.05),且超重及肥胖组较正常组耐受二甲双胍的剂量较大(P<0.01)。结论老年2型糖尿病患者中,体重超重及肥胖者较体重正常者更易耐受二甲双胍。Objective Digestive disorders represent the most common side effects of metformin, while the mechanism remains unclear. This study assessed whether body mass index （BMI） could influence metformin tolerance in elderly people with type 2 diabetes mellitus. Methods Data were obtained from 257 elderly people with type 2 diabetes, which divided into normal weight group, overweight group and obesity group by BMI. The study duration was 4 weeks. All subjects started taking metformin from 500 mg/d to 1500 mg/d progressively. Gastrointestinal side effects were assessed each week and metformin dose was adjusted by the compliance. Gastrointestinal side effects were compared in three groups. Results In totally 257 subjects, 100 were normal weight （72.6 ±7.7） yr, 107 were overweight （70.2 ±7.0） yr and 50 were obesity （71.1 ± 8.0） yr. At baseline, the scoring of gastrointestinal symptoms showed no statistical difference in three groups. After 4 weeks, for gastrointestinal symptoms such as bloating and anorexia, the respective percentages in overweight and obesity group were lower than that in normal weight group （P〈0.05）. The final metformin dose was higher in overweight and obesity group than that in normal weight group （P〈0.01）. Conclusions In elderly people with diabetes, people who are overweight and obesity present better metformin tolerance than normal weight.

关 键 词：二甲双胍 胃肠道不良反应 老年2型糖尿病 体质指数 

分 类 号：R587.1[医药卫生—内分泌]