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Metformin May Delay Onset of Diabetes in At-Risk Subjects
二甲双胍可延缓危险人群向糖尿病发展。
NEW YORK (Reuters Health) Mar 24 - In non-diabetics who are at risk for developing diabetes, treatment with metformin leads to modest improvements in weight, lipid profiles and fasting glucose, and substantial reductions in insulin resistance and new-onset of diabetes, results of a meta-analysis indicate.
纽约3月24日路透社健康新闻报道，相关数据表明，采用二甲双胍对可能发展为糖尿病的非糖尿病患者进行治疗，可使体重，血脂，空腹血糖等得到一定程度的改善，而胰岛素耐受和初发糖尿病患者，采用二甲双胍治疗后，上述指标则表现为大幅降低。
Dr. Shelley R. Salpeter from Stanford University School of Medicine, California and colleagues pooled data from 31 trials that compared metformin with placebo or no treatment in 4570 adults at risk for diabetes followed for 8267 patient-years.
来自加利福尼亚斯坦福大学医学院的Shelley R. Salpeter博士及其同事们对31个临床试验数据进行了汇总，这些试验对4570例糖尿病早期患者进行了二甲双胍和安慰剂或不采取治疗的对比研究。该类糖尿病高危人群每年有8267个病例发生。
Metformin treatment, compared with placebo or no treatment, reduced body mass index by 5.3%, fasting glucose by 4.5%, fasting insulin by 14.4%, and calculated insulin resistance by 22.6%, according to the report in the February issue of the American Journal of Medicine.
根据美国医学杂志2月刊报道，与服用安慰剂或不进行治疗相比，服用二甲双胍治疗可以使体重指数降低5.3%，空腹血糖降低4.5%，空腹胰岛素水平降低14.4%，累积胰岛素耐受降低22.6%。
Metformin treatment also reduced triglycerides and LDL cholesterol by 5.3% and 5.6%, respectively, and increased HDL cholesterol by 5.0% compared with placebo or no treatment.
与安慰剂和不治疗组相比，二甲双胍治疗同样也降低了甘油三酯和LDL脂蛋白水平，降幅分别为5.3%和5.6%，同时，还使HDL脂蛋白的水平提高了5.0%。
"The incidence of new-onset diabetes was reduced by 40% (odds ratio, 0.6), with an absolute risk reduction of 6%, during a mean trial duration of 1.8 years," the investigators found.
新发糖尿病的比例被降低了40%（优势率0.6），绝对风险降低了6%，在平均为期为1.8年的研究中，研究者发现。
Dr. Salpeter and colleagues think metformin could be added to diet and exercise if these lifestyle modifications alone are not sufficient to reduce the risk of diabetes in at-risk individuals.
Salpeter 博士和他的同事们认为可以在饮食和运动疗法之外增加使用二甲双胍辅助治疗早期糖尿病，如果仅仅凭借生活方式的改变并不足以延缓高危人群发展成为糖尿病。
"Future long-term trials will be needed to show that the metabolic benefits of metformin treatment result in a reduction in cardiovascular morbidity and mortality," they conclude.
今后将需要进行长期实验来研究使用二甲双胍对代谢的有益影响，为什么结果会使得心血管疾病发病率和死亡率下降。他们总结说。
Am J Med 2008;121:149-157.
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