二甲双胍对2型糖尿病胰岛素抵抗患者糖脂代谢及脂肪因子的影响  

Effect of metformin on glucose and lipid metabolism and fat factor in type 2 diabetes patients with insulin resistance

作　　者：赵涛[1] 乐静[1] 李传静[1] 刘爱林[1] 

机构地区：[1]武汉科技大学附属孝感医院内分泌科,湖北孝感432000

出　　处：《安徽医药》2016年第7期1382-1385,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的研究二甲双胍对2型糖尿病胰岛素抵抗患者糖脂代谢及脂肪因子的影响。方法 120例2型糖尿病患者分为二甲双胍组(n=60)和单纯胰岛素组(n=60),单纯胰岛素组只进行胰岛素治疗,二甲双胍组在胰岛素治疗基础上加用二甲双胍,测定两组患者治疗前后胰岛素功能(FINS、PINS、HOMA-IR)、糖脂代谢指标(FBG、PBG、Hb A1C、TG、TC、LDL-C、HDLC、FFA)、脂肪因子(瘦素、内脂素、抵抗素、脂联素、网膜素、Vaspin)。结果治疗后,两组患者的FINS、HOMA-IR、FBG、PBG、HbA_1C、TG、FFA、瘦素和抵抗素水平均明显降低,与治疗前比较差异均具有统计学意义(P<0.05)。且二甲双胍组治疗后FINS、HOMA-IR、FBG、PBG、Hb A1C、TG、FFA、瘦素和抵抗素水平均低于单纯胰岛素治疗后的水平(P<0.05)。而两组患者的PINS、TC和HDL-C均无明显变化。治疗后二甲双胍组的内脂素和Vaspin水平均明显降低,网膜素水平明显上升,差异均具有统计学意义,而二甲双胍组的脂联素水平无明显变化。治疗后单纯胰岛素组内脂素、Vaspin、网膜素和脂联素的水平均无明显变化。结论二甲双胍可明显改善2型糖尿病胰岛素抵抗患者糖脂代谢及脂肪因子的水平,特别是对内脂素、Vaspin、网膜素等脂肪因子的影响,提示二甲双胍治疗2型糖尿病的机制不仅是通过改善糖脂代谢,还可能与改善内脂素、Vaspin、网膜素等脂肪因子有关。Objective To study the effect of metformin on glucose and lipid metabolism and fat factor in type 2 diabetes patients with insulin resistance. Methods Totally 120 patients with type 2 diabetes were randomized into metformin group（ n = 60） and insulin alone group（ n = 60）. Insulin alone group only received insulin therapy while metformin group received metformin and insulin therapy.Before and after treatment,insulin function（ FINS,PINS,HOMA- IR）,glucose and lipid metabolism（ FBG,PBG,Hb A1 C,TG,TC,LDL- C,HDL- C,FFA）,adipokines（ leptin,visfatin,resistin,adiponectin,omentin,Vaspin） in the two groups of patients were compared. Results After treatment,levels of FINS,HOMA- IR,FBG,PBG,Hb A1 C,TG,FFA,leptin and resistin in two groups were significantly reduced,showing statistically significant difference compared with those before treatment（ P〈0.05）. And after treatment FINS,HOMA- IR,FBG,PBG,Hb A1 C,TG,FFA,leptin and resistin levels in metformin group were lower than those in insulin alone group（ P〈0.05）. Levels of PINS,TC and HDL- C did not change significantly. Compared with those before treatment,levels of visfatin and vaspin in metformin group were significantly lower and omentin levels were significantly increased,indicating statistically significant difference. However adiponectin level in metformin group had no significant change. Levels of visfatin,Vaspin,omentin and adiponectin in insulin group did not change significantly after treatment. Conclusions Metformin could significantly improve the metabolism of glucose and lipid as well as fat factor in type 2 diabetes patients with insulin resistance,particularly its effect on levels of visfatin,Vaspin,omentin,suggesting that the possible mechanism of metformin exerting its efficacy on type 2 diabetes with insulin resistance is not only by improving metabolism of glucose and lipid but also by involving the improvement of fat factors,such as visfatin,vaspin and omentin.

关 键 词：糖尿病 2型 二甲双胍 脂肪因子类 

分 类 号：R587.1[医药卫生—内分泌]