Kravchuk Ekaterina, Grineva Elena, Bairamov Alekber, Galagudza Michael, Vlasov Timur
Institute of Endocrinology, Almazov Federal Heart, Blood and Endocrinology Centre, Akkuratova Street 2, St. Petersburg 197341, Russia.
Exp Diabetes Res. 2011;2011:907496. doi: 10.1155/2011/907496. Epub 2011 Jun 22.
In recent years, evidence has been accumulated that metformin, an antidiabetic drug in the biguanide class, in addition to its well-recognized glucose-lowering effect, can also reduce cardiovascular mortality in the patients with type 2 diabetes mellitus (T2DM). Besides, there are a few experimental studies on the possibility of the direct anti-ischemic effect of the drug in both type 1 diabetes mellitus and T2DM. In our study, myocardial tolerance to ischemia in rats with neonatal streptozotocin T2DM was investigated using the model of global ischemia-reperfusion of the isolated perfused heart. Metformin was administered i.p. at a dose of 200 mg/kg/day for 3 days prior to isolated heart perfusion. The results showed that both the infarct size and postischemic recovery of left ventricular function were not different between controls and metformin-treated animals. At the same time, the infarct size in the T2DM animals was significantly lower than that in the controls (24.4 ± 7.6% versus 45.0 ± 10.4%, resp., P < .01), indicative of the metabolic preconditioning in T2DM. It follows that the protocol of metformin administration used in this study had not elicited cardioprotective effect in animals with T2DM so that the different mechanism(s) may underlie the beneficial effect of metformin on cardiovascular complications in patients with T2DM which, however, would need further investigation.
近年来,已有证据表明,双胍类抗糖尿病药物二甲双胍除了具有公认的降糖作用外,还能降低2型糖尿病(T2DM)患者的心血管死亡率。此外,还有一些关于该药物在1型糖尿病和T2DM中直接抗缺血作用可能性的实验研究。在我们的研究中,使用离体灌注心脏的全心缺血-再灌注模型,研究了新生链脲佐菌素诱导的T2DM大鼠的心肌缺血耐受性。在离体心脏灌注前3天,以200mg/kg/天的剂量腹腔注射二甲双胍。结果显示,对照组和二甲双胍治疗组动物的梗死面积和缺血后左心室功能恢复情况并无差异。同时,T2DM动物的梗死面积显著低于对照组(分别为24.4±7.6%和45.0±10.4%,P<.01),表明T2DM存在代谢预处理。由此可见,本研究中使用的二甲双胍给药方案并未在T2DM动物中引发心脏保护作用,因此,二甲双胍对T2DM患者心血管并发症有益作用的潜在机制可能不同,不过这还需要进一步研究。