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目的探讨二甲双胍对初发2型糖尿病(T2DM)及糖耐量异常(IGT)者的疗效。方法初发T2DM、IGT患者各30例,健康志愿者30例,分别设为T2DM组、IGT组及正常对照组,比较各组血糖、糖化血红蛋白(HbA1c)、血脂、血压、体质量指数(BMI)、腰臀比(WHR)、尿酸(UA)、血浆脂联素及内脂素的差异。T2DM组及IGT组患者在合理膳食和适当运动的同时加服二甲双胍1500mg/d,疗程为1年,检测治疗前后各项指标的变化。用酶联免疫吸附法检测血浆脂联素、内脂素水平;血总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-c)、低密度脂蛋白胆固醇(LDL-c)和UA用全自动生化仪测定;空腹血糖(FPG)和糖负荷后2h血糖(2hPG)采用葡萄糖氧化酶法,HbA1c测定采用高压液相法。结果①与对照组相比,IGT组及T2DM组BMI、TC、FPG、2hPG和HbA1c显著增高(P<0.01,P<0.05),脂联素和内脂素水平明显降低(P<0.05,P<0.01);②二甲双胍治疗后,T2DM组BMI、WHR、TC、FPG、2hPG和HbA1c较治疗前明显降低(P<0.05或P<0.01),IGT组BMI、WHR、LDL-c、TC、FPG和2hPG显著降低(P<0.05或P<0.01),但两组脂联素均明显高于治疗前(P<0.01,P<0.05)。结论初发T2DM及IGT患者在生活方式改善的同时服用二甲双胍干预治疗疗效明确。
Objective To investigate the curative effect of metformin on newly diagnosed type 2 diabetes mellitus (T2DM) and impaired glucose tolerance (IGT). Methods Thirty newborns with T2DM and IGT were enrolled in this study. Thirty healthy volunteers and 30 healthy volunteers were enrolled in this study. The T2DM group, IGT group and normal control group were enrolled in this study. Blood glucose, HbA1c, blood lipid, blood pressure, body mass index ), Waist-to-hip ratio (WHR), uric acid (UA), plasma adiponectin and visfatin. Patients in T2DM group and IGT group were given metformin 1500mg / d for reasonable diet and appropriate exercise for one year, and the changes of various indexes before and after treatment were detected. Plasma adiponectin and visfatin levels were measured by enzyme-linked immunosorbent assay. Blood levels of TC, TG, HDL-c and LDL- c) and UA by automatic biochemical analyzer; fasting blood glucose (FPG) and glucose load 2h glucose (2hPG) using glucose oxidase method, HbA1c determination using high pressure liquid phase method. Results ① Compared with the control group, the levels of BMI, TC, FPG, 2hPG and HbA1c in IGT group and T2DM group were significantly increased (P <0.01, P <0.05), and adiponectin and visfatin decreased significantly <0.01). ② After treatment with metformin, the levels of BMI, WHR, TC, FPG, 2hPG and HbA1c in T2DM group were significantly lower than those before treatment (P <0.05 or P <0.01) And 2hPG decreased significantly (P <0.05 or P <0.01), but both groups were significantly higher than those before treatment (P <0.01, P <0.05). Conclusions Patients with newly diagnosed T2DM and IGT have a definite improvement in their lifestyle while taking metformin intervention.