English P J, Ashcroft A, Patterson M, Dovey T M, Halford J C G, Harrison J, Eccleston D, Bloom S R, Ghatei M A, Wilding J P H
Diabetes and Endocrinology Research Group, University Hospital Aintree, Liverpool, UK.
Diabetes Metab Res Rev. 2007 May;23(4):299-303. doi: 10.1002/dmrr.681.
Weight loss is difficult to achieve in type 2 diabetes and many therapies are associated with weight gain, an effect attenuated by metformin. We studied the effects of metformin on energy expenditure, appetite and the regulation of PYY and ghrelin in type 2 diabetes.
Plasma peptide YY (PYY), ghrelin, resting metabolic rate (RMR), postprandial thermogenesis (PPTG), and appetite ratings were measured at baseline and following a mixed meal in 11 type 2 diabetic subjects treated with diet alone (T2D) and 10 treated with metformin monotherapy (T2MF). The groups were similar in age, gender and adiposity.
There were no differences in baseline anthropometric, or metabolic variables between the groups. Postprandially, plasma ghrelin fell equally in both groups (23% versus 24.5%, p < 0.05 versus baseline, p = NS between groups) but were reduced for longer in T2MF (below baseline 60-240 min T2MF versus 60-180 min T2D) coincidentally with a prolonged sensation of fullness and suppression of hunger in the metformin-treated group. There were no differences in PYY concentrations, RMR or PPTG.
Metformin prolongs the postprandial fall in ghrelin concentrations. These effects may prolong the inter-meal interval, thereby decreasing snack intake and daily energy intake, promoting weight loss.
2型糖尿病患者很难实现体重减轻，许多治疗方法还会导致体重增加，而二甲双胍可减轻这种影响。我们研究了二甲双胍对2型糖尿病患者能量消耗、食欲以及肽YY（PYY）和胃饥饿素调节的影响。
对11例仅接受饮食治疗的2型糖尿病患者（T2D）和10例接受二甲双胍单药治疗的患者（T2MF），在基线时和进食混合餐后测量血浆肽YY（PYY）、胃饥饿素、静息代谢率（RMR）、餐后产热（PPTG）和食欲评分。两组在年龄、性别和肥胖程度方面相似。
两组之间的基线人体测量学或代谢变量没有差异。餐后，两组血浆胃饥饿素均同等下降（分别下降23%和24.5%，与基线相比p<0.05，两组之间p=无显著性差异），但T2MF组下降时间更长（T2MF组在60 - 240分钟低于基线，而T2D组在60 - 180分钟），同时二甲双胍治疗组饱腹感延长且饥饿感受到抑制。PYY浓度、RMR或PPTG没有差异。
二甲双胍可延长餐后胃饥饿素浓度的下降时间。这些作用可能会延长餐间间隔时间，从而减少零食摄入量和每日能量摄入量，促进体重减轻。
