Eltonsy Sherif, Dufour Doiron Monique, Simard Patrice, Jose Caroline, Sénéchal Martin, Bouchard Danielle R, LeBlanc Rémi, Bélanger Mathieu
Centre de formation médicale du Nouveau-Brunswick, Canada, Université de Moncton, Canada.
Vitalité Health Network.
J Int Med Res. 2019 Mar;47(3):1131-1145. doi: 10.1177/0300060518817164. Epub 2019 Jan 7.
To evaluate the impact of the combination of metformin and exercise on changes in glycated hemoglobin (HbA), functional capacity, the lipid profile, quality of life, and weight.
Data from a 12-week cardiovascular rehabilitation program (2014–2016) were retrospectively evaluated. Metformin exposure was determined through recorded prescriptions, and average minutes of exercise per week were computed from exercise logs. The primary outcomes were changes in HbA and functional capacity (6-minute walk test [6MWT]) over 12 weeks. The secondary outcomes were changes in the lipid profile, quality of life, and weight. Directed acyclic graphs were used to identify potential confounders, accounted for with multiple linear regression.
The cohort comprised 403 patients (85 metformin users, 318 non-users). The average amount of exercise was 102.7±48.7 minutes/week among metformin users and 107.7±58.1 minutes/week among non-users. Although changes in HbA were similar for both groups, the coefficient for the metformin–exercise interaction indicated significantly greater improvements in the 6MWT among metformin users. There were no between-group differences in any secondary outcomes.
The combination of metformin and exercise led to greater gains in functional capacity than exercise alone. This combination did not appear to influence the effects of either treatment on other outcomes.
评估二甲双胍与运动相结合对糖化血红蛋白（HbA）变化、功能能力、血脂谱、生活质量和体重的影响。
对一项为期12周的心血管康复计划（2014 - 2016年）的数据进行回顾性评估。通过记录的处方确定二甲双胍的使用情况，并根据运动日志计算每周的平均运动分钟数。主要结局是12周内HbA和功能能力（6分钟步行试验[6MWT]）的变化。次要结局是血脂谱、生活质量和体重的变化。使用有向无环图来识别潜在的混杂因素，并通过多元线性回归进行分析。
该队列包括403名患者（85名二甲双胍使用者，318名非使用者）。二甲双胍使用者的平均运动量为每周102.7±48.7分钟，非使用者为每周107.7±58.1分钟。尽管两组的HbA变化相似，但二甲双胍与运动相互作用的系数表明，二甲双胍使用者在6MWT中的改善明显更大。次要结局在两组之间没有差异。
二甲双胍与运动相结合比单独运动能带来更大的功能能力提升。这种组合似乎并未影响两种治疗对其他结局的效果。
