二甲双胍对肥胖合并混合糖调节受损的干预研究

目的观察二甲双胍对肥胖合并混合糖调节受损干预治疗的效果。方法根据口服葡萄糖耐量试验将肥胖合并混合糖调节受损患者160例随机分为对照组及研究组,对照组以糖尿病饮食及运动治疗为主,研究组在运动及饮食治疗的基础上加用二甲双胍缓释片（0.5g,每日1次）治疗,随访3年,定期（半年）测定两组间治疗前后空腹血糖（FPG）、餐后2h血糖（2hPG）、体质量指数（BMI）、空腹胰岛素水平（FINS）、瘦素（Leptin）、游离脂肪酸（FFA）,并做统计学分析。结果两组治疗后糖尿病发生率有显著差异（P〈0.05）。研究组治疗前后空腹血糖、空腹胰岛素水平、BMI、瘦素、游离脂肪酸的比较显示：治疗后各项指标下降,有统计学意义（P〈0.05）,餐后2h血糖有所下降,但无统计学意义;而对照组治疗前后各项指标未见显著变化（P〉0.05）。结论二甲双胍通过降低血糖,减轻体重而改善了胰岛素抵抗状态,从而阻止糖调节受损向2型糖尿病发展,可作为肥胖合并混合糖调节受损人群糖尿病预防的选择。

Intervention of participants with composite impaired glucose regulation and obesity by Metformin

Objective To observe the effects of intervention in participants with composite impaired glucose regulation and obesity by Metformin. Methods One hundred and sixty participants with impaired glucose regulation and obesity who were diagnosed by oral glucose tolerance test were randomly divided into control group and treatment group. Participants in control group received diabetic diet and physical training, and those in the treatment group were treated by Metformin sustained-releasing tablets （0.5 g, once every day） plus diabetic diet and physical training. Fasting plasma glucose （FPG）, 2hPG, body mass index （BMI）, fasting insulin （FINS） and free fatty acid （FFA） were determined per 6 months during a follow-up period of 3 years for statistical analysis. Results The FPG, FINS, BMI, and FFA were markedly reduced after treatment in the treatment group （P〈0.05）, and the 2hPG was reduced but had no statistically significant difference （P〉0.05）. There was significant difference in each index in control group before and after treatment （P〈0.05）. Condusion Metformin can prevent the development of impaired glucose regulation to type 2 diabetic mellitus by reducing the plasma glucose and BM, and improving the state of insulin resistance. Therefore, Metformin can prevent the morbidity of diabetes in the population with impaired glucose regulation and obesity.