二甲双胍餐前给药联合或不联合急性运动对代谢综合征患者餐后血脂和血糖反应的影响：一项随机、开放标签、交叉研究。

Effect of Pre-Meal Metformin With or Without an Acute Exercise Bout on Postprandial Lipemic and Glycemic Responses in Metabolic Syndrome Patients: A Randomized, Open Label, Crossover Study.

机构信息

University of Manouba, High Institute of Sport and Physical Education, Ksar Said, Tunis, Tunisia.

LR12SP11, Biochemistry Department, Sahloul University Hospital, Sousse, Tunisia.

出版信息

J Cardiovasc Pharmacol Ther. 2023 Jan-Dec;28:10742484231156318. doi: 10.1177/10742484231156318.

DOI:10.1177/10742484231156318

PMID:36802839

Abstract

INTRODUCTION

Both exercise and pre-meal metformin could lower postprandial glucose and lipid profiles.

AIMS

To explore whether pre-meal metformin administration is superior to metformin administration with the meal in reducing postprandial lipid and glucose metabolism, and whether its combination with exercise confer superior benefits in metabolic syndrome patients.

MATERIALS AND METHODS

In a randomized crossover design, 15 metabolic syndrome patients were assigned to 6 sequences including 3 experimental conditions: metformin administration with a test meal (met-meal), metformin administration 30 min prior to a test meal (pre-meal-met) with or without an exercise bout designed to expend 700 Kcal at 60% VO peak performed the evening just before pre-meal-met condition. Only 13 participants (3 males, 10 females; age: 46 ± 9.86, HbA1c: 6.23 ± 0.36) were included in the final analysis.

RESULTS

Postprandial triglyceridemia was unaffected by any condition (all > .05). However, both pre-meal-met (-7.1%, = .009) and pre-meal-metx (-8.2%, = .013) significantly reduced total cholesterol AUC with no significant differences between the two latter condition ( = .616). Similarly, LDL-cholesterol levels were significantly lower during both pre-meal-met (-10.1%, = .013) and pre-meal-metx (-10.7%, = .021) compared to met-meal with no difference between latter conditions ( = .822). Plasma glucose AUC was significantly reduced by pre-meal-metx compared to both pre-meal-met (-7.5%, = .045) and met-meal (-8%, = .03). Insulin AUC was significantly lower during pre-meal-metx compared to met-meal (-36.4%, = .044).

CONCLUSIONS

Metformin administration 30 minutes prior to meal seems to exert favorable effects on postprandial TC and LDL-Cholesterol levels compared to its administration with meal. Addition of one exercise bout only improved postprandial glycemia and insulinemia.

TRIAL REGISTRY

Pan African clinical trial registry, Identifier PACTR202203690920424.

摘要

介绍

运动和餐前二甲双胍均可降低餐后血糖和血脂谱。

目的

探讨餐前二甲双胍给药是否优于随餐给药，以降低餐后脂质和葡萄糖代谢，以及其与运动结合是否在代谢综合征患者中具有更好的益处。

材料和方法

采用随机交叉设计，将 15 例代谢综合征患者分为 6 个序列，包括 3 个实验条件：随餐二甲双胍给药（met-meal）、餐前 30 分钟给予二甲双胍（pre-meal-met），以及在晚餐前进行设计以消耗 700 卡路里的 60% VO 峰值的运动。只有 13 名参与者（3 名男性，10 名女性；年龄：46 ± 9.86，HbA1c：6.23 ± 0.36）被纳入最终分析。

结果

任何条件都不会影响餐后甘油三酯（均 >.05）。然而，pre-meal-met（-7.1%， =.009）和 pre-meal-metx（-8.2%， =.013）均显著降低了总胆固醇 AUC，两者之间没有显著差异（ =.616）。同样，与 met-meal 相比，LDL 胆固醇水平在 pre-meal-met（-10.1%， =.013）和 pre-meal-metx（-10.7%， =.021）期间均显著降低，后两者之间无差异（ =.822）。与 met-meal 相比，pre-meal-metx 使血浆葡萄糖 AUC 显著降低（-7.5%， =.045）和 pre-meal-met（-8%， =.03）。与 met-meal 相比，pre-meal-metx 时胰岛素 AUC 显著降低（-36.4%， =.044）。