Top Wiebe M C, Kooy Adriaan, Stehouwer Coen D A
Department of Intensive Care, Treant Care Group, 7909 AA Hoogeveen, The Netherlands.
Department of Internal Medicine, Treant Care Group, 7909 AA Hoogeveen, The Netherlands.
Pharmaceuticals (Basel). 2022 Mar 4;15(3):312. doi: 10.3390/ph15030312.
The biguanide metformin has been used as first-line therapy in type 2 diabetes mellitus (T2DM) treatment for several decades. In addition to its glucose-lowering properties and its prevention of weight gain, the landmark UK Prospective Diabetes Study (UKPDS) demonstrated cardioprotective properties in obese T2DM patients. Coupled with a favorable side effect profile and low cost, metformin has become the cornerstone in the treatment of T2DM worldwide. In addition, metformin is increasingly being investigated for its potential anticancer and neuroprotective properties both in T2DM patients and non-diabetic individuals. In the meantime, new drugs with powerful cardioprotective properties have been introduced and compete with metformin for its place in the treatment of T2DM. In this review we will discuss actual insights in the various working mechanisms of metformin and the evidence for its beneficial effects on (the prevention of) cardiovascular disease, cancer and dementia. In addition to observational evidence, emphasis is placed on randomized trials and recent meta-analyses to obtain an up-to-date overview of the use of metformin in clinical practice.
几十年来，双胍类药物二甲双胍一直被用作2型糖尿病（T2DM）治疗的一线疗法。除了具有降血糖特性和防止体重增加外，具有里程碑意义的英国前瞻性糖尿病研究（UKPDS）表明，二甲双胍对肥胖的T2DM患者具有心脏保护作用。再加上良好的副作用 profile 和低成本，二甲双胍已成为全球T2DM治疗的基石。此外，越来越多的研究在T2DM患者和非糖尿病个体中探究二甲双胍潜在的抗癌和神经保护特性。与此同时，具有强大心脏保护特性的新药已被推出，并与二甲双胍竞争其在T2DM治疗中的地位。在这篇综述中，我们将讨论二甲双胍各种作用机制的实际见解，以及其对（预防）心血管疾病、癌症和痴呆有益作用的证据。除了观察性证据外，重点还放在随机试验和近期的荟萃分析上，以获得二甲双胍在临床实践中应用的最新概况。
