The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Diabetes Res Clin Pract. 2022 Sep;191:110073. doi: 10.1016/j.diabres.2022.110073. Epub 2022 Sep 6.
This study aims to further clarify whether the addition of metformin to insulin treatment improve cardiovascular and cerebrovascular risk factors in individuals with T1DM.
Electronic databases were searched for randomized controlled trials in which the efficacy and safety of metformin were compared with those of a placebo for risk factors of cardiovascular and cerebrovascular disease among individuals with T1DM, and a meta-analysis was conducted.
Thirteen cardiovascular studies were identified. In the metformin group, mean carotid intimal media thickness was significantly reduced by 0.03 mm, ascending aortic pulse wave velocity by 6.3 m/s, descending aortic wall shear stress by 1.77 dyn/cm (P = 0.02), insulin daily dose by 0.05 U/kg/d, body weight by 2.27 kg, fat-free mass by 1.32 kg, body mass index by 0.58 kg/m, hip circumference by 0.29 m, and low-density lipoprotein by 0.16 mmol/L, all above are P < 0.05. In the metformin group, flow-mediated dilation was increased by 1.29 %, glucose infusion rate/insulin by 18.22 mg/(kg⋅min)/μIU/μL, and waist-to-hip ratio by 0.02, all above are P < 0.00001. The metformin group showed no differences in blood pressure, reactive hyperemia index, waist circumference, triglyceride, total cholesterol, high-density lipoprotein cholesterol, or body mass index Z score. For cerebrovascular studies were identified. But none of them had a risk factor assessment.
Metformin can ameliorate cardiovascular and cerebrovascular risk factors through non-hypoglycemic multiple pathways in individuals with T1DM.
本研究旨在进一步阐明在 T1DM 个体中，加用二甲双胍治疗是否能改善心血管和脑血管危险因素。
检索电子数据库，寻找比较二甲双胍与安慰剂对 T1DM 个体心血管和脑血管疾病危险因素疗效和安全性的随机对照试验，并进行荟萃分析。
共确定了 13 项心血管研究。在二甲双胍组，颈动脉内膜中层厚度平均减少 0.03mm，升主动脉脉搏波速度降低 6.3m/s，降主动脉壁切应力增加 1.77dyn/cm（P=0.02），胰岛素日剂量减少 0.05U/kg/d，体重减少 2.27kg，去脂体重减少 1.32kg，体重指数减少 0.58kg/m，臀围减少 0.29m，低密度脂蛋白减少 0.16mmol/L，所有这些差异均有统计学意义（P<0.05）。在二甲双胍组，血流介导的舒张功能增加 1.29%，葡萄糖输注率/胰岛素增加 18.22mg/（kg·min）/μIU/μL，腰臀比增加 0.02，所有这些差异均有统计学意义（P<0.00001）。二甲双胍组的血压、反应性充血指数、腰围、甘油三酯、总胆固醇、高密度脂蛋白胆固醇或体重指数 Z 评分无差异。共确定了 13 项脑血管研究。但它们均没有危险因素评估。
二甲双胍通过非低血糖的多种途径改善 T1DM 个体的心血管和脑血管危险因素。
