二甲双胍对胰岛素抵抗患者血脂和胰岛素敏感性的影响

目的：研究二甲双胍对2型糖尿病合并高血压病患血脂和胰岛素敏感性的影响。方法：将76例2型糖尿病合并高血压病患分为31例治疗组与45例对照组，并与26例2型糖尿病组相比。三组应用格列齐特或格列吡嗪降糖，治疗组加用二甲双胍0．5g,3次／d，治疗组与对照组用卡托普利或依那普利降压。治疗2个月后胰岛素及C肽兴奋试验，测胰岛素、C肽浓度、空腹血糖、血脂，计计算胰岛素敏感指数、C肽与胰岛素面积。治疗前后测体重指数。结果：对照组的胰岛素、C肽浓度及面积与2型糖尿病组相比，上升非常显，胰岛素敏感指数降低25．17％；治疗组的C肽及胰岛素面积上升显，胰岛素敏感指数降低11．31％，总胆固醇、载脂蛋白B降低，高密度脂蛋白胆固醇、载脂蛋白A1上升，治疗组治疗后体重指数下降显。结论：二甲双胍能改善2型糖尿病合并高血压病患的血脂代谢，提高胰岛素敏感性。

The effect of metformin on blood lipid and insulin resistance of type 2 diabetic patients complicated with essential hypertension

Objective To study the effect of metformin on blood lipid and insulin resistance of type 2 diabetic patients complicated with essential hypertension. Methods 76 cases of type 2 diabetes mellitus complicated with essential hypertension were divided into 31 cases of treatment group and 45 cases of control group. Both groups were compared with 26 cases of type 2 diabetes mellitus group. The three groups took gliclazide or glipizide to control blood glucose and the treatment group also took metformin 0.5g three times a day. Both treatment and control groups used captopril or enalapril to control blood pressure. Insulin and c-peptide stimulating test were made after two months treatment ,measuring insulin?c-peptide?fasting blood glucose?blood lipid concentrations, calculating insulin sensitivity index?c-peptide and insulin areas. Body mass indexes were measured before and after treatment. Results Compared with type 2 diabetes mellitus group, the control group's insulin and c-peptide concentrations and areas were very significantly higher(p<0.01), insulin sensitivity index was 25.17% lower; the treatment group's insulin and c-peptide areas were significantly higher(p<0.05), insulin sensitivity index was 11.31% lower; total cholesterol and apolipoprotein B decreased while high density lipoprotein cholesterol and apolipoprotein A1 increased. Body mass index of the treatment group decreased after treatment (p<0.05). Conclusion Metformin can improve blood lipid pattern and insulin sensitivity of type 2 diabetic patients complicated with essential hypertension.