CAJ | 학술논문

目的观察二甲双胍1 g顿服对2型糖尿病(T2DM)患者脂餐后代谢的急性影响,探讨其降糖机理及临床新用途. 方法初诊T2DM、葡萄糖耐量低减(IGT)患者共30例,按胰岛素抵抗指数(Homa-IR)＞2、Homa-IR≤2分为A、B两组,观察服二甲双胍+脂餐及对照脂餐后8 h内血糖、胰岛素(INS)、血脂变化. 结果在糖化血红蛋白(HbA1c)、空腹、餐后血糖及体重指数(BMI)相似情况下,A组显示高胰岛素血症,餐后长时间高甘油三酯(TG)血症及胰岛素抵抗.二甲双胍1 g顿服显著抑制A组餐后2 h血糖、游离脂肪酸(FFA),长达8 h的TG及8 h低密度脂蛋白(LDL)水平(P均＜0.05)而不引起胰岛素变化,而B组未见显著改变. 结论 1 g二甲双胍在胰岛素抵抗的T2DM及IGT患者起了明显的胰岛素增敏作用,此作用是通过直接或间接促进TG的清除或利用实现的.
목적관찰이갑쌍고1 g돈복대2형당뇨병(T2DM)환자지찬후대사적급성영향,탐토기강당궤리급림상신용도. 방법초진T2DM、포도당내량저감(IGT)환자공30례,안이도소저항지수(Homa-IR)＞2、Homa-IR≤2분위A、B량조,관찰복이갑쌍고+지찬급대조지찬후8 h내혈당、이도소(INS)、혈지변화. 결과재당화혈홍단백(HbA1c)、공복、찬후혈당급체중지수(BMI)상사정황하,A조현시고이도소혈증,찬후장시간고감유삼지(TG)혈증급이도소저항.이갑쌍고1 g돈복현저억제A조찬후2 h혈당、유리지방산(FFA),장체8 h적TG급8 h저밀도지단백(LDL)수평(P균＜0.05)이불인기이도소변화,이B조미견현저개변. 결론 1 g이갑쌍고재이도소저항적T2DM급IGT환자기료명현적이도소증민작용,차작용시통과직접혹간접촉진TG적청제혹이용실현적.
Objective To investigate the mechanism of metformin action through the acute effect of metformin on postpradial metabolism of glucose and lipid. Methods 30 cases of new diagnosed T2DM and IGT were divided into A,B groups according to Homa IR>2 and ≤2.All subjects in 2 groups were given study breakfast (600 Kcal,fat 35%,CHO50%,protein 15%)for 2 times with interval of 1 3 days.The lunch was missed.Their BG,Insulin,TC,TG,LDL,FFA,HDL levels at postpradial 2,4,6,8 h were compared betwen control day and oral 1.0 g of metformin study day. Results Under the same levels of HbA 1c,FBG,P 2 hBG and BMI in both groups,the subjects in A group had much higher hyperinsulinmia, insulin resistance and hyperglyceridemia than group B. 1.0 g of metformin significantly suppressed the increase of the levels of P2 h BG, P2 h FFA,P8h LDL and TG for 8 h ( P <0.05) without significant changes of serum insulin only in group A but not in group B. Conclusion Acute effect of metformin as an insulin sensitizing agent in patients with insulin resistance and T2DM/IGT were at least in part mediated by the increase of clearing and disposal of free fatty acid and triglyceride.