Sirtori C R, Tremoli E, Sirtori M, Conti F, Paoletti R
Atherosclerosis. 1977 Apr;26(4):583-92. doi: 10.1016/0021-9150(77)90125-3.
The triglyceride-lowering effect of metformin (N,N-dimethylbiguanide) was tested in a series of patients with stable hypertriglyceridemia (types IIB, III and IV) and with variable degrees of glucose intolerance. Metformin caused a 38% mean decrease of plasma triglycerides. A selective decrease of very low density lipoprotein cholesterol was observed without reciprocal increase of low density lipoproteins. Thirty patients completed the study. Eighteen, who showed a hypotriglyceridemic effect exceeding 30%, were considered as "Responders"; the other 12, where the effect was negligible, were considered as "Non-Responder". Analysis of the pre-and post-treatment glucose tolerance tests of Responders and Non-Responders showed that the former had, on the average, a normal glucose tolerance and insulin secretion, whereas the latter had an impaired glucose tolerance with increased insulin secretion. These parameters were only slightly modified by metformin. The conclusions of this study support the hypothesis that biguanides exert a triglyceride-lowering effect by decreasing lipoprotein secretion, independent of changes in glucose tolerance and/or insulin secretion.
在一系列患有稳定型高甘油三酯血症（IIB型、III型和IV型）且糖耐量程度各异的患者中，测试了二甲双胍（N，N - 二甲基双胍）降低甘油三酯的效果。二甲双胍使血浆甘油三酯平均降低了38%。观察到极低密度脂蛋白胆固醇有选择性降低，而低密度脂蛋白没有相应增加。30名患者完成了该研究。其中18名甘油三酯降低效果超过30%的患者被视为“反应者”；另外12名效果可忽略不计的患者被视为“无反应者”。对反应者和无反应者治疗前后糖耐量试验的分析表明，前者平均具有正常的糖耐量和胰岛素分泌，而后者糖耐量受损且胰岛素分泌增加。这些参数仅被二甲双胍轻微改变。本研究的结论支持这样的假设，即双胍类药物通过减少脂蛋白分泌发挥降低甘油三酯的作用，与糖耐量和/或胰岛素分泌的变化无关。
