Wajchenberg B L, Halpern A, Leme C E, Lerário A C, Silveria A A, Fioratti P A, Cesar F P
Metabolism. 1976 Sep;25(9):957-71. doi: 10.1016/0026-0495(76)90125-6.
A standard 4-hr ethanol infusion (236 mg/min) after a 3-day fast with and without phenformin (25 mg q.i.d.), with blood drawn every hour for 8 hr, was performed on five normal subjects, eight obese nondiabetics, seven obese chemical diabetics, and four nonobese diabetics. Control infusion induced in all subjects a decline in blood sugar levels during and/or after the alcohol challenge, with a parallel decrease in basal plasma insulin. Hypoglycemia and the decrease in insulin secretion were associated with increased plasma free fatty acid concentration. Addition of phenethylbiguanide (PBG) to the preparatory 3-day fast resulted in a greater drop in the blood glucose levels of the normal control subjects, obese and nonobese diabetics; in the obese nondiabetics, however, significantly lower degree of blood glucose decrease than control was elicited. Furthermore, obese nondiabetics altered their blood glucose-insulin interaction with apparent increased responsivess of the B cells of PBG. The results suggest that effects of phenformin on blood glucose levels are more dependent on the metabolic state of the patient than on a property of the drug itself.
在五名正常受试者、八名肥胖非糖尿病患者、七名肥胖化学性糖尿病患者和四名非肥胖糖尿病患者身上进行了一项实验，在禁食3天后，分别进行标准的4小时乙醇输注（236毫克/分钟），其中一部分同时服用苯乙双胍（25毫克，每日四次），每小时采血一次，共采8小时血样。对照输注在所有受试者中均导致酒精激发期间和/或之后血糖水平下降，同时基础血浆胰岛素水平平行降低。低血糖和胰岛素分泌减少与血浆游离脂肪酸浓度升高相关。在为期3天的准备性禁食期间添加苯乙双胍（PBG）后，正常对照受试者、肥胖和非肥胖糖尿病患者的血糖水平下降幅度更大；然而，肥胖非糖尿病患者的血糖下降程度明显低于对照组。此外，肥胖非糖尿病患者改变了他们的血糖-胰岛素相互作用，PBG对B细胞的反应性明显增加。结果表明，苯乙双胍对血糖水平的影响更多地取决于患者的代谢状态，而不是药物本身的特性。
