Department of Clinical Pharmacology, Canterbury District Health Board, Christchurch, New Zealand.
Br J Clin Pharmacol. 2009 Dec;68(6):875-82. doi: 10.1111/j.1365-2125.2009.03372.x.
Metformin treatment of Type 2 diabetes is not usually associated with weight gain, and may assist with weight reduction. Plasma ghrelin concentrations are inversely associated with obesity and food intake. Metformin might therefore affect ghrelin concentrations, although previous studies have shown variable results in this regard. The primary aim of this study was to determine the effect of metformin on plasma ghrelin, appetite and satiety in patients with Type 2 diabetes.
Eighteen patients with Type 2 diabetes were studied before and after 6 weeks of metformin treatment, which was titrated to 1 g b.d. On the study days patients were fed standard meals of 390 kcal at 08.00 and 12.30 h, plasma samples were collected at 15- and 30-min intervals, and appetite and satiety were measured on visual analogue scales. Changes in the area under the concentration-time curves (AUCs) of plasma ghrelin, insulin, glucose, appetite and satiety were assessed and examined for correlations with metformin AUCs. Changes in fasting adiponectin and leptin were also measured.
Treatment with metformin increased the mean AUC (07.30-16.30 h) of plasma ghrelin by 24% (P= 0.003), while decreasing those of glucose by 19% (P < 0.001) and insulin by 19% (P= 0.001). No changes were detected in hunger and satiety, or in fasting adiponectin or leptin concentrations. There were no clear correlations between metformin plasma concentrations (AUC) and changes in plasma glucose, insulin or ghrelin.
Treatment of Type 2 diabetes with metformin was associated with increased plasma ghrelin concentrations, without associated changes in hunger and satiety.
与其他主要的降血糖药物不同，二甲双胍不会导致体重增加。
胃饥饿素是一种促进食欲的激素，其浓度随食物、肥胖和糖尿病控制而变化。
关于二甲双胍如何影响胃饥饿素浓度的报告存在矛盾，本研究旨在解决 2 型糖尿病患者中的这一问题。
在这项研究中，2 型糖尿病患者在接受二甲双胍治疗后，胃饥饿素浓度升高。
如果二甲双胍对体重控制的影响是通过抑制胃饥饿素来介导的，那么这种效果可能与预期相反。
这种情况很可能是由于血糖控制改善所致。
食欲和饱腹感的餐时变化与胃饥饿素的变化无关，这表明胃饥饿素可能在进食启动中并不重要。
2 型糖尿病的二甲双胍治疗通常不会导致体重增加，并且可能有助于减轻体重。
血浆胃饥饿素浓度与肥胖和食物摄入呈负相关。
因此，二甲双胍可能会影响胃饥饿素浓度，尽管以前的研究在这方面显示出不同的结果。
本研究的主要目的是确定二甲双胍对 2 型糖尿病患者血浆胃饥饿素、食欲和饱腹感的影响。
18 例 2 型糖尿病患者在接受 6 周的二甲双胍治疗前后接受了研究，二甲双胍的剂量逐渐增加至 1 g，每天两次。
在研究日，患者在 08.00 和 12.30 时进食 390 卡路里的标准餐，每隔 15-30 分钟采集一次血浆样本，并使用视觉模拟量表测量食欲和饱腹感。
评估了血浆胃饥饿素、胰岛素、葡萄糖、食欲和饱腹感的浓度-时间曲线下面积（AUC）的变化，并检查了与二甲双胍 AUC 的相关性。还测量了空腹脂联素和瘦素的变化。
二甲双胍治疗使血浆胃饥饿素的平均 AUC（07.30-16.30 h）增加了 24%（P=0.003），同时使血糖的 AUC 降低了 19%（P <0.001），胰岛素的 AUC 降低了 19%（P=0.001）。
饥饿感和饱腹感、空腹脂联素或瘦素浓度没有变化。
二甲双胍血浆浓度（AUC）与血浆葡萄糖、胰岛素或胃饥饿素的变化之间没有明显的相关性。
