二甲双胍对肥胖型2型糖尿病患者脂代谢、氧化应激因子及胰岛素抵抗的影响  

Effects of Metformin on Lipid Metabolism,Oxidative Stress Factors and Insulin Resistance in Obese Patients with Type 2 Diabetes Mellitus

作　　者：兰天[1] 邱平[1] 刘巍梦 邹阳 LAN Tian;QIU Ping;LIU Weimeng;ZOU Yang(Dept.of Endocrinology and Metabolism,the First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China;Dept.of Gynecology,the Sixth People’s Hospital of Panzhihua,Sichuan Panzhihua 617023,China;Dept.of Internal Medicine,Chongqing Ninth People’s Hospital,Chongqing 400700,China)

机构地区：[1]成都医学院第一附属医院内分泌代谢科,成都610500 [2]攀枝花市第六人民医院妇科,四川攀枝花617023 [3]重庆市第九人民医院内科,重庆400700

出　　处：《中国医院用药评价与分析》2023年第7期788-790,795,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：四川省教育厅科研项目(No.18ZB0167)。

摘　　要：目的:探讨二甲双胍对肥胖型2型糖尿病患者脂代谢、氧化应激因子及胰岛素抵抗的影响。方法:选择2020年1月至2021年3月成都医学院第一附属医院收治的肥胖型2型糖尿病患者120例,按照随机数字表法分为对照组与观察组,各60例。两组患者均给予常规饮食控制,安排适宜的运动和作息。在此基础上,对照组患者给予吡咯列酮,1次15 mg,1日1次;瑞格列奈,1次1 mg,1日3次,餐前服用。观察组患者在对照组基础上加用二甲双胍,1次0.5 g,1日3次,随餐服用。持续治疗6个月后,观察两组患者的相应疗效指标。结果:治疗后,两组患者空腹血糖、餐后2 h血糖和糖化血红蛋白水平较治疗前明显降低;总胆固醇、三酰甘油和低度脂蛋白胆固醇水平较治疗前明显降低,高密度脂蛋白胆固醇水平明显升高;与对照组比较,观察组患者上述血脂指标变化更为显著,上述差异均有统计学意义(P<0.05)。治疗后,两组患者体重指数均较治疗前明显降低,且观察组患者降低更为显著,差异均有统计学意义(P<0.05)。对照组患者治疗后的胰岛素抵抗指数与治疗前相比未降低;观察组患者治疗后的胰岛素抵抗指数较治疗前明显降低,差异有统计学意义(P<0.05)。治疗后,两组患者的超氧化物歧化酶、谷胱甘肽过氧化物酶及丙二醛水平较治疗前明显降低,且观察组患者上述氧化应激因子水平变化更为显著,差异均有统计学意义(P<0.05)。两组患者低血糖、恶心呕吐、头晕、皮疹及低血压等不良反应发生率的差异无统计学意义(P>0.05)。结论:肥胖型2型糖尿病患者口服二甲双胍,不仅可有效控制血糖水平、降低氧化应激水平,还可以有效缓解脂代谢紊乱以及改善胰岛素抵抗。OBJECTIVE:To probe into the effects of metformin on lipid metabolism,oxidative stress factors and insulin resistance in obese patients with type 2 diabetes mellitus.METHODS:A total of 120 obese patients with type 2 diabetes mellitus admitted into the First Affiliated Hospital of Chengdu Medical College from Jan.2020 to Mar.2021 were extracted to be divided into the control group and observation group via the random number table method,with 60 cases in each group.Both groups were given routine diet control,appropriate exercise and rest.On this basis,the control group was given pyrrolitazone,15 mg for once,once a day;repaglinide was given 1 mg once,3 times a day,before meals.The observation group was given metformin on the basis of the control group,0.5 g for once,3 times a day,with meals.After continuous treatment for 6 months,the corresponding curative effect indicators of two groups were observed.RESULTS:After treatment,the levels of fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin in two groups decreased significantly compared with before treatment;the levels of total cholesterol,triglyceride and low density lipoprotein cholesterol decreased significantly compared with before treatment,while the levels of high density lipoprotein cholesterol increased significantly;compared with the control group,the observation group showed more significant changes in the above blood lipid indicators,with statistically significant differences(P<0.05).After treatment,the body mass index of both groups decreased significantly,and the decrease was more significant in the observation group,with statistically significant differences(P<0.05).The insulin resistance index of control group did not decrease after treatment compared with before treatment;the insulin resistance index of observation group decreased significantly compared with before treatment,the difference was statistically significant(P<0.05).After treatment,the levels of superoxide dismutase,glutathione peroxidase and malondialdehyde in t

关 键 词：二甲双胍 肥胖 2型糖尿病 脂代谢 氧化应激因子 胰岛素抵抗 

分 类 号：R977.15[医药卫生—药品]