Biomedical Research and Innovation Platform, South African Medical Research Council, Tygerberg, 7505, South Africa; Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, 60131, Italy.
School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, 4000, South Africa.
Pharmacol Res. 2021 Jan;163:105219. doi: 10.1016/j.phrs.2020.105219. Epub 2020 Oct 2.
Metformin is a widely used glucose-lowering drug, although its impact on adipose tissue function remains elusive. Adipose tissue-derived molecules regulate diverse physiological mechanisms, including energy metabolism, insulin sensitization, and inflammatory response. Alternatively, it has remained relevant to understand the therapeutic regulation of adipokines in efforts to alleviate inflammation in conditions associated with the metabolic syndrome. The current qualitative analysis of available literature focused on randomized clinical trials (RCTs) assessing the association between administration of metformin and adipokine regulation in individuals with metabolic syndrome. The major electronic databases such as MEDLINE, Cochrane Library, Scopus, and EMBASE were searched for eligible RCTs. Overall, 13 RCTs met the inclusion criteria, with a total of 4605 participants. Patients with metabolic syndrome were characterized by a state of obesity, impaired glucose tolerance, insulin resistance, and type 2 diabetes. Cumulative evidence from these RCTs supported the blood glucose lowering effects of metformin, in addition to promoting weight loss, ameliorating insulin resistance, and reducing pro-inflammatory markers such as interleukin-6 and tumor necrosis factor-α in patients with metabolic syndrome. Importantly, these therapeutic effects are associated with the upregulation of adiponectin and suppression of leptin and resistin.
二甲双胍是一种广泛使用的降血糖药物，但其对脂肪组织功能的影响仍不清楚。脂肪组织来源的分子调节多种生理机制，包括能量代谢、胰岛素敏感性和炎症反应。相反，了解脂肪因子的治疗调节对于缓解代谢综合征相关疾病中的炎症仍然很重要。目前对现有文献的定性分析侧重于评估二甲双胍给药与代谢综合征个体中脂肪因子调节之间关联的随机临床试验 (RCT)。主要的电子数据库，如 MEDLINE、Cochrane 图书馆、Scopus 和 EMBASE，都被用来搜索合格的 RCT。共有 13 项 RCT 符合纳入标准，共有 4605 名参与者。代谢综合征患者的特征是肥胖、葡萄糖耐量受损、胰岛素抵抗和 2 型糖尿病。这些 RCT 的累积证据支持二甲双胍的降血糖作用，此外还能促进体重减轻、改善胰岛素抵抗，并降低代谢综合征患者的促炎标志物，如白细胞介素-6 和肿瘤坏死因子-α。重要的是，这些治疗效果与脂联素的上调和瘦素和抵抗素的抑制有关。
