Kim Kyunam
Department of Family Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
Korean J Fam Med. 2024 Sep;45(5):258-267. doi: 10.4082/kjfm.24.0156. Epub 2024 Aug 23.
Metformin is widely used drugs in the treatment of type 2 diabetes mellitus. However, the mechanisms of action are complex and are still not fully understood yet. Metformin has a dose-dependent blood sugar-lowering effect. The most common adverse reactions of metformin are gastrointestinal symptoms, and women tend to be more experienced than men. A positive correlation between the administration of duration and the daily dose of metformin and the risk of vitamin B12 deficiency is confirmed. Novel glucose-lowering mechanism through the activation of AMP-activated protein kinase and alteration of gut microbiota composition is identified. In addition, metformin has immunomodulatory properties in various mechanisms, including anti-inflammatory actions, and so forth. Metformin improves insulin sensitivity, which may reduce the risk of tumor growth in certain cancers. The antiviral effects of metformin may occur through several mechanisms, including blocking angiotensin converting enzyme 2 receptor, and so forth. These potential mechanisms of metformin are promising in various clinical settings, such as inflammatory diseases, autoimmune diseases, cancer, and coronavirus disease 2019.
二甲双胍是治疗2型糖尿病的广泛使用的药物。然而,其作用机制复杂,尚未完全明确。二甲双胍具有剂量依赖性的降糖作用。二甲双胍最常见的不良反应是胃肠道症状,女性比男性更易出现。已证实二甲双胍的给药持续时间和日剂量与维生素B12缺乏风险之间呈正相关。通过激活AMP活化蛋白激酶和改变肠道微生物群组成,发现了新的降糖机制。此外,二甲双胍在多种机制中具有免疫调节特性,包括抗炎作用等。二甲双胍可改善胰岛素敏感性,这可能降低某些癌症中肿瘤生长的风险。二甲双胍的抗病毒作用可能通过多种机制发生,包括阻断血管紧张素转换酶2受体等。二甲双胍的这些潜在机制在各种临床环境中,如炎症性疾病、自身免疫性疾病、癌症和2019冠状病毒病中都很有前景。