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目的:观察二甲双胍对老年非糖尿病代谢综合征(MS)的干预效果及可能机制。方法:将90例老年非糖尿病MS患者随机分为两组,对照组行单纯的科学生活方式干预,二甲双胍组在此基础上加服二甲双胍,干预前及干预后半年分别测量空腹体重指数(BMI)、血糖(FBG)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、血浆脂联素水平(APN)、胰岛素(FINS),并计算胰岛素敏感性指数(ISI)等。结果:干预半年后对照组上述指标仅有轻度改善,除TG较前下降(P<0.05)外,其他指标与干预前比较,差异无显著性(P>0.05)。二甲双胍组BMI、TG、FBG、FINS均较前明显下降(P<0.05,P<0.01);APN、ISI均较治疗前明显升高(P<0.01),与对照组比较差异有显著性(P<0.05,P<0.01)。结论:生活方式加二甲双胍药物干预可提高老年非糖尿病MS患者的血浆APN水平,增加胰岛素敏感性,改善各项代谢指标。
Objective: To observe the effect of metformin on senile non-diabetic metabolic syndrome (MS) and its possible mechanism. Methods: 90 elderly patients with non-diabetic MS were randomly divided into two groups. The control group was treated with simple scientific lifestyle intervention. Metformin group was given metformin on the basis of the above. Before and after the intervention, the body mass index (BMI) , FBG, TG, HDL-C, APN, FINS, insulin sensitivity index (ISI) and so on. Results: After six months of intervention, the above indexes of the control group only mildly improved except for the former TG decreased (P <0.05), while the other indexes had no significant difference (P> 0.05). The levels of BMI, TG, FBG and FINS in metformin group were significantly lower than those in the control group (P <0.05, P <0.01), while the APN and ISI levels in the metformin group were significantly higher than those before treatment (P <0.01) <0.05, P <0.01). Conclusion: Life-style and metformin intervention can increase plasma APN level in elderly patients with non-diabetic MS and increase insulin sensitivity and improve various metabolic parameters.