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Diana Abdalhk, Michael C Riddell, Sarah Swayze, Jennifer L Kuk
School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
Endocrinol Diabetes Metab. 2020 Dec 15;4(2):e00206. doi: 10.1002/edm2.206. eCollection 2021 Apr.
To examine the combined association between metformin use and physical activity on HbA1c in adults with type 2 diabetes.
Adults with type 2 diabetes from NHANES continuous survey (1999-2018, n = 6447) were classified as active and inactive based on self-reported engagement in moderate-to-vigorous or vigorous physical activity (MVPA or VigPA) and metformin use over the last month.
There was a significant negative main effect of metformin usage on HbA1c levels, independent of whether individuals engaged in modest levels of MVPA or VigPA. Moreover, there was a higher prevalence of metformin users with a HbA1c < 6.5% than non-metformin users with no differences by activity status (36.1%-39.5% versus 24.9%-29.7%, respectively). There was a significantly lower HbA1c level ( = .007) and trend for a higher odds of having a HbA1c that achieved the clinical target of <7% (OR, 95% CI = 1.2, 1.0-1.4, = .06) in the MVPA than non-MVPA group for only those not using metformin. For those using metformin, there was no difference in HbA1c levels by either MVPA or VigPA (both > .05).
There appears to be independent benefits of metformin and regular physical activity on glucose control, but the impact of these two treatments are not necessarily additive. Based on this analyses, the benefit of physical activity on HbA1c levels in type 2 diabetes is likely more apparent in those not taking metformin, as compared to those who are.
研究二甲双胍的使用和体力活动对 2 型糖尿病成人糖化血红蛋白（HbA1c）的联合影响。
根据自我报告的过去一个月内中等至剧烈或剧烈体力活动（MVPA 或 VigPA）和二甲双胍使用情况，将 NHANES 连续调查（1999-2018 年，n=6447）中的 2 型糖尿病成年人分为活跃和不活跃两类。
无论个体是否进行适度的 MVPA 或 VigPA，二甲双胍的使用都对 HbA1c 水平有显著的负向主要影响。此外，HbA1c<6.5%的二甲双胍使用者的比例高于未使用二甲双胍且无活动状态差异的患者（分别为 36.1%-39.5%和 24.9%-29.7%）。MVPA 组的 HbA1c 水平显著降低（=0.007），HbA1c 达到<7%的临床目标的可能性也更高（OR，95%CI=1.2，1.0-1.4，=0.06），而不使用二甲双胍的非 MVPA 组则没有这种趋势。对于未使用二甲双胍的患者，MVPA 或 VigPA 对 HbA1c 水平均无影响（均>0.05）。
二甲双胍和规律体力活动对血糖控制均有独立益处，但这两种治疗方法的影响不一定具有累加性。基于本分析，与服用二甲双胍的患者相比，未服用二甲双胍的 2 型糖尿病患者的体力活动对 HbA1c 水平的影响可能更为明显。
