二甲双胍的降糖及降糖外作用

Effects within and beyond hypoglycemic of Metformin

关键词:  二甲双胍  糖尿病  肿瘤  心血管事件  多囊卵巢综合征  非酒精性脂肪肝

Key words:  Metformin  diabetes mellitus  tumor  cardiovascular events  PCOS  NAFLD

摘要:

二甲双胍减少肝脏糖异生作用，增加外周组织胰岛素敏感性，改善胰岛素抵抗和较少不良反应的优势，为临床治疗2型糖尿病的一线用药并贯穿治疗始终达50年之久。新近研究发现，除降血糖外，其还拥有改善脂代谢、保护心血管、抑制肿瘤、治疗非酒精性脂肪肝和多囊卵巢综合征等作用。临床治疗糖尿病合并其他疾病患者，发现其不良反应主要是胃肠道反应，罕见乳酸酸中毒。在循证医学和大量临床实验支持下，二甲双胍的降糖外作用有望如降糖作用一般具有重要意义。

Abstract:

With the advantages of reducing hepatic gluconeogenesis，increasing insulin sensitivity of peripheral tissue，ameliorating insulin resistance and less adverse reaction.Metformin has been the first-line drug in the treatment of type Ⅱ diabetes mellitus along the whole course for almost fifty years.Increasing researches have indicated recently that Metformin can also improve lipid metabolism，protect cardiovascular，inhibit tumor growth，treat non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS)，apart from reducing blood sugar.Gastrointestinal side effects are common in clinical application，while lactic acidosis is scarce.With the support of evidence-based medicine and large quantities of clinical trials，we believe that the referred effects of Metformin can be as uniquely irreplaceable as its hypoglycemic effect.