二甲双胍在衰老相关疾病中的应用。
Use of metformin in diseases of aging.
作者信息
Miles John M, Rule Andrew D, Borlaug Barry A
机构信息
Divisions of Endocrinology, Nephrology and Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA,
出版信息
Curr Diab Rep. 2014 Jun;14(6):490. doi: 10.1007/s11892-014-0490-4.
Metformin is the most commonly prescribed medication for type 2 diabetes (T2DM) in the world. It has primacy in the treatment of this disease because of its safety record and also because of evidence for reduction in the risk of cardiovascular events. Evidence has accumulated indicating that metformin is safe in people with stage 3 chronic kidney disease (CKD-3). It is estimated that roughly one-quarter of people with CKD-3 and T2DM in the United States (well over 1 million) are ineligible for metformin treatment because of elevated serum creatinine levels. This could be overcome if a scheme, perhaps based on pharmacokinetic studies, could be developed to prescribe reduced doses of metformin in these individuals. There is also substantial evidence from epidemiologic studies to indicate that metformin may not only be safe, but may actually benefit people with heart failure (HF). Prospective, randomized trials of the use of metformin in HF are needed to investigate this possibility.
二甲双胍是全球最常用于治疗2型糖尿病（T2DM）的药物。由于其安全记录以及有证据表明可降低心血管事件风险，它在这种疾病的治疗中占据首要地位。越来越多的证据表明，二甲双胍对3期慢性肾脏病（CKD - 3）患者是安全的。据估计，在美国，约四分之一的CKD - 3合并T2DM患者（超过100万）因血清肌酐水平升高而不符合二甲双胍治疗的条件。如果能够制定一个方案，或许基于药代动力学研究，为这些个体开具降低剂量的二甲双胍，这个问题就可以得到解决。流行病学研究也有大量证据表明，二甲双胍不仅可能是安全的，而且实际上可能对心力衰竭（HF）患者有益。需要进行关于二甲双胍用于HF的前瞻性、随机试验来研究这种可能性。
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