Hollenbeck C B, Johnston P, Varasteh B B, Chen Y D, Reaven G M
Department of Medicine, Stanford University School of Medicine, CA.
Diabete Metab. 1991 Sep-Oct;17(5):483-9.
The effect of metformin treatment was studied in nine patients with mild (fasting plasma glucose concentration less than 7.5 mmol.l-1) non-insulin-dependent diabetes mellitus (NIDDM) and fasting plasma triglyceride (TG) concentration greater than 2.0 mmol.l-1. Individuals were studied before and three months after receiving 2.5 g/day of metformin. Mean hourly plasma glucose concentration from 8 AM to 4 PM (7.5 +/- 0.5 vs 6.5 +/- 0.4 mmol.l-1, p less than 0.001), as well as glycosylated hemoglobin levels (7.0 +/- 0.5 vs 6.2 +/- 0.2%, p less than 0.02) were significantly lower following metformin treatment. The improvement in glycaemic control was not associated with an improvement in insulin stimulated glucose disposal as measured by the glucose clamp technique. Mean hourly day-long concentrations of plasma insulin (519 +/- 81 vs 364 +/- 64 pmol.l-1, p less than 0.001), FFA (502 +/- 45 vs 460 +/- 35 mu mol.l-1, p less than 0.01), and triglyceride (3.60 +/- 0.33 vs 3.02 +/- 0.31 mmol.l-1, p less than 0.001) concentrations were significantly lower following three months of metformin treatment. Finally, fasting plasma TG concentration, very low density lipoprotein (VLDL)-TG, and VLDL-cholesterol concentrations were significantly decreased, while high density lipoprotein (HDL)-cholesterol concentration was significantly increased following metformin therapy. Thus, metformin administration to individuals with NIDDM, who did not have significant fasting hyperglycaemia, led to a decrease in plasma glucose, insulin, FFA, and TG concentration, and an increase in plasma HDL-cholesterol concentration.(ABSTRACT TRUNCATED AT 250 WORDS)
对9例轻度（空腹血糖浓度低于7.5 mmol·l⁻¹）非胰岛素依赖型糖尿病（NIDDM）且空腹血浆甘油三酯（TG）浓度高于2.0 mmol·l⁻¹的患者进行了二甲双胍治疗效果的研究。在个体接受每日2.5 g二甲双胍治疗前及治疗三个月后进行研究。上午8点至下午4点的平均每小时血浆葡萄糖浓度（7.5±0.5 vs 6.5±0.4 mmol·l⁻¹，p＜0.001）以及糖化血红蛋白水平（7.0±0.5 vs 6.2±0.2%，p＜0.02）在二甲双胍治疗后显著降低。血糖控制的改善与通过葡萄糖钳夹技术测量的胰岛素刺激的葡萄糖处置改善无关。二甲双胍治疗三个月后，全天平均每小时血浆胰岛素浓度（519±81 vs 364±64 pmol·l⁻¹，p＜0.001）、游离脂肪酸（FFA）浓度（502±45 vs 460±35 μmol·l⁻¹，p＜0.01）和甘油三酯浓度（3.60±0.33 vs 3.02±0.31 mmol·l⁻¹，p＜0.001）显著降低。最后，空腹血浆TG浓度、极低密度脂蛋白（VLDL）-TG和VLDL-胆固醇浓度显著降低，而高密度脂蛋白（HDL）-胆固醇浓度在二甲双胍治疗后显著升高。因此，对无显著空腹高血糖的NIDDM个体给予二甲双胍可导致血浆葡萄糖、胰岛素、FFA和TG浓度降低，以及血浆HDL-胆固醇浓度升高。（摘要截选至250字）
