Department of Kinesiology, University of Massachusetts Amherst, USA.
Am J Physiol Endocrinol Metab. 2010 Apr;298(4):E815-23. doi: 10.1152/ajpendo.00517.2009. Epub 2010 Jan 13.
Results from the Diabetes Prevention Program highlight the effectiveness of metformin or regular physical activity in the prevention of type 2 diabetes. Independently, metformin and exercise increase insulin sensitivity, but they have not been studied in combination. To assess the combined effects, insulin-resistant subjects (n = 9) matched for weight, body fat, and aerobic fitness were studied before any treatment (B), after 2-3 wk of 2,000 mg/day metformin (MET), and after metformin plus 40 min of exercise at 65% Vo(2peak) (MET + Ex). A second group (n = 7) was studied at baseline and after an identical bout of exercise with no metformin (Ex). Biopsies of the vastus lateralis were taken at B, after MET, immediately after MET + Ex (group 1), or immediately after Ex (group 2). Insulin sensitivity was assessed 4 h postexercise with a euglycemic hyperinsulinemic (40 mU.m(2).min(-1)) clamp enriched with [6,6-(2)H]glucose. Insulin sensitivity was 54% higher after Ex (P < 0.01), but there was no change with Met + Ex. Skeletal muscle AMPKalpha2 activity was elevated threefold (P < 0.01) after Ex, but there was no increase with MET + Ex. These findings suggest that the combination of short-term metformin treatment and an acute bout of exercise does not enhance insulin sensitivity, and the addition of metformin may attenuate the well-documented effects of exercise alone.
结果来自糖尿病预防计划强调了二甲双胍或有规律的体育活动在预防 2 型糖尿病的有效性。独立地，二甲双胍和运动增加胰岛素敏感性，但它们尚未被联合研究。为了评估联合效应，胰岛素抵抗的受试者（n = 9）按体重、体脂肪和有氧健身匹配，在任何治疗前（B）、在 2000 毫克/天二甲双胍（MET）治疗 2-3 周后和 MET 加 65% Vo（2peak）（MET + Ex）40 分钟运动后进行研究。第二组（n = 7）在基线和没有二甲双胍的相同运动后进行研究（Ex）。股外侧肌活检在 B、MET 后、MET + Ex（第 1 组）后立即或 Ex（第 2 组）后立即进行。在富含[6,6-（2）H]葡萄糖的 40 mU.m（2）.min（-1）的正常血糖高胰岛素血症钳夹中，在运动后 4 小时评估胰岛素敏感性。Ex 后胰岛素敏感性提高 54%（P < 0.01），但 MET + Ex 后没有变化。Ex 后骨骼肌 AMPKalpha2 活性升高三倍（P < 0.01），但 MET + Ex 后没有增加。这些发现表明，短期二甲双胍治疗和急性运动的联合并不能提高胰岛素敏感性，并且添加二甲双胍可能会减弱运动的良好记录的效果。
