二甲双胍对消化道恶性肿瘤合并糖耐量异常患者胰岛β细胞功能的影响  

Effect of metformin on the function of isletβ-cell function in patients with gastrointestinal cancer and impaired glucose tolerance

作　　者：吴文清 柯传庆 王占科 沈建伟[4] 马少华[5] 邓文松 孙玲 WU Wenqing;KE Chuanqing;WANG Zhanke;SHEN Jianwei;MA Shaohua;DENG Wensong;SUN Ling(Department of Oncology,the 908 Hospital of Joint Logistic Support Force,Nanchang,Jiangxi 330002,China;Medical Department of Ningbo Meikang Shengde Medical Laboratory,Ningbo,Zhejiang 315040,China;Department of Clinical Laboratory,the 908 Hospital of Joint Logistic Support Force,Nanchang,Jiangxi 330002,China;Department of Gastroenterology,Li Huili Hospital Ningbo Medical Center,Ningbo,Zhejiang 315000,China;College of Medical Technology,Ningbo Health Vocational and Technical College,Ningbo,Zhejiang 315040,China)

机构地区：[1]联勤保障部队第908医院肿瘤科,江西南昌330002 [2]宁波美康盛德医学检验所医学部,浙江宁波315040 [3]联勤保障部队第908医院检验科,江西南昌330002 [4]宁波市医疗中心李惠利医院消化科,浙江宁波315000 [5]宁波卫生职业技术学院医学技术学院,浙江宁波315040

出　　处：《检验医学与临床》2024年第18期2724-2727,共4页Laboratory Medicine and Clinic

基　　金：江西省卫生健康委员会课题资助项目(20190315);浙江省宁波市重点研发项目(2023Z159)。

摘　　要：目的分析二甲双胍对恶性消化道肿瘤合并糖耐量异常患者胰岛β细胞功能的影响。方法选取2019年6月至2023年6月在联勤保障部队第908医院就诊的120例恶性消化道肿瘤合并糖耐量异常患者作为研究对象,按照随机数字表法将其分为二甲双胍治疗组及治疗对照组,各60例,另选取同期在联勤保障部队第908医院体检的60例健康人群作为健康组。比较3组空腹血糖(GLU0)、空腹乳酸(LA0)、稳态模式评估法胰岛素分泌指数(HOMA-β)、糖负荷30 min后胰岛素增量和血糖增量(ΔINS30/ΔGLU30)比值、糖负荷30 min后乳酸(LA30)、糖负荷30 min后乳酸增量和血糖增量(ΔLA30/ΔGLU30)比值、血清肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平。结果治疗对照组GLU0、LA0、TNF-α、IL-6水平及ΔLA30/ΔGLU30比值高于健康组和二甲双胍治疗组,差异均有统计学意义(P<0.05)。二甲双胍治疗组HOMA-β、ΔINS30/ΔGLU30比值低于健康组,而高于治疗对照组,差异均有统计学意义(P<0.05)。结论二甲双胍可有效减轻炎症反应,改善恶性消化道肿瘤合并糖耐量异常患者胰岛β细胞功能不全和糖代谢障碍。Objective To analyze the effects of metformin on the function of isletβcells in patients with gastrointestinal cancer and impaired glucose tolerance.Methods A total of 120 patients with gastrointestinal cancer and impaired glucose tolerance were selected from the 908 Hospital of the Joint Logistic Support Force from June 2019 to June 2023 as study objects and were divided into metformin treatment group and treatment control group according to random number table method,with 60 cases in each group.Another 60 healthy people who underwent physical examination in the 908 Hospital of the Joint Logistic Support Force during the same period were selected as the healthy group.Fasting blood glucose(GLU0),fasting lactate(LA0),insulin secretion index by homeostatic model assessment(HOMA-β),ratio of insulin increment to blood glucose increment after 30 min of glycemic load(ΔINS30/ΔGLU30),lactate after 30 min of glycemic load(LA30),ratio of lactate increment to blood glucose increment after 30 min of glycemic load(ΔLA30/ΔGLU30)ratio,serum tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels of the 3 groups were compared.Results The levels of GLU0,LA0,TNF-α,IL-6 andΔLA30/ΔGLU30 ratio in the treatment control group were higher than those in the healthy group and the metformin treatment group,and the differences were statistically significant(P<0.05).The HOMA-βandΔINS30/ΔGLU30 ratio of metformin treatment group were lower than those of the healthy group,and those of metformin treatment group were higher than those of the treatment control group,and the differences were all statistically significant(P<0.05).Conclusion Metformin can effectively reduce the inflammatory response and improve isletβ-cell insufficiency and glucose metabolism disorders in patients with gastrointestinal cancer and impaired glucose tolerance.

关 键 词：二甲双胍 恶性消化道肿瘤 糖耐量异常 胰岛Β细胞功能 炎症因子 

分 类 号：R246.5[医药卫生—针灸推拿学] R714.255[医药卫生—中医临床基础]