二甲双胍对糖尿病前期患者生长分化因子15及体脂分布影响的研究

目的探讨二甲双胍对DM前期患者生长分化因子15(GDF-15)及体脂分布的影响。方法选取DM前期患者112例,随机分为标准生活方式干预+二甲双胍的试验组(Exp)和仅标准生活方式干预的对照组(Con),每组各56例。干预1年后比较两组体重、BMI、WC、体脂分布、血糖、Ins、GDF-15等指标变化。再以BMI≥24 kg/m²为标准分为超重/肥胖组和体重正常组,多元线性回归分析GDF-15的影响因素。结果干预1年后Exp组FPG、2 h PG低于Con组(P<0.05),定量IS指数(QUICKI)、GDF-15高于Con组(P<0.05);超重/肥胖组TC、TG、HbA₁c、2 h Ins、WC、内脏脂肪面积、四肢、A区及G区脂肪质量较前降低(P<0.05),GDF-15较前升高(P<0.05)。Spearman相关分析显示,GDF-15与年龄、QUICKI呈正相关(r=0.362、0.375,P<0.05),与FIns呈负相关(r=-0.353,P<0.05)。多元线性回归分析显示,应用二甲双胍是GDF-15的影响因素,应用二甲双胍是A区脂肪质量的影响因素。结论二甲双胍干预可减少DM前期患者腹部脂肪,升高GDF-15,且在超重/肥胖人群更显著。

Effects of Metformin on GDF-15 and adipose tissue distribution in prediabetic patients

ObjectiveTo explore the effects of Metformin on growth differentiation factor 15(GDF-15)and body fat distribution in patients with pre-diabetes.MethodsA randomized controlled clinical trial was conducted on 112 subjects with pre-diabetes,who were randomly divided into experimental group(standard lifestyle intervention combined with Metformin,Exp n=56)and control group(standard lifestyle intervention,Con n=56).The changes in body weight,BMI,WC,body fat distribution,PG,Ins,and GDF-15 were compared between the two groups after 1 year follow-up.The objects were divided into overweight/obese group and normal weight group according to whether BMI≥24 kg/m²in multiple linear regression analysis to explore the influencing factors of GDF-15.ResultsAfter one year of intervention,FPG and 2 hPG in Exp group were significantly lower than those in Con group(P<0.05),while QUICKI index and GDF-15level were higher than those in Con group(P<0.05).After one year’s intervention,TC,TG,HbA₁c,2 hIns,WC,visceral fat area,fat mass of limbs,A and G areas in overweight/obesity group decreased(P<0.05)and GDF-15 increased(P<0.05).Spearman correlation analysis showed that GDF-15 was positively correlated with age and QUICKI after one year of intervention(r=0.362,0.375,P<0.05),and negatively correlated with FIns(r=-0.353,P<0.05).Multiple regression analysis showed that Metformin was the influencing factor of GDF-15 in overweight/obesity group,and related with fat quality in area A.ConclusionMetformin treatment can reduce abdominal fat mass and increase GDF-15 in patients with pre-diabetes,especially in overweight/obese people.