摘要
目的:观察不同剂量二甲双胍对老年2型糖尿病患者骨密度和骨代谢的影响。方法:未经治疗的老年2型糖尿病患者102例随机分为二甲双胍低剂量组(n=34)、二甲双胍中剂量组(n=34)和二甲双胍高剂量组(n=34)。3组分别给予:二甲双胍0.5 g,每日2次;二甲双胍0.5 g,每日3次;二甲双胍0.5 g,每日4次。3组均连续口服3个月。服药前和服药后1、3个月分别测定患者腰椎(L2-4)与股骨颈(Neck)的骨密度(BMD)及血骨特异性碱性磷酸酶(BAP)、骨钙素(BGP)以及抗酒石酸酸性磷酸酶(TRACP)、护骨因子(OPG)、空腹血糖(FBG)和糖化血红蛋白水平(Hb Al C)。结果:3组治疗后FBG和Hb Al C均明显降低,与治疗前比较差异有统计学意义(P<0.05),但3组间同期比较无统计学差异(P>0.05)。3组治疗前、后反映骨代谢的骨抑制指标TRACP和OPG无明显变化;反映骨转换与形成的指标BGP和BAP治疗后均升高,治疗前、后有统计学差异(P<0.05)。其中,二甲双胍高剂量组和中剂量组的BGP和BAP同期高于低剂量组,组间比较有统计学差异(P<0.05),而二甲双胍中剂量组和高剂量组的BGP和BAP同期无统计学差异(P>0.05)。3组治疗3个月后腰椎(L2-4)与股骨颈(Neck)的BMD均明显增加,二甲双胍高剂量组和中剂量组分别与低剂量组比较有统计学差异,但二甲双胍高剂量组和中剂量组并没有明显差异。结论:二甲双胍对老年性2型糖尿病患者在发挥降糖作用的同时,还能使患者BMD得到改善,该作用可能主要是通过促进骨形成实现的,且疗效有一定剂量相关性。
AIM ： To observe the effect of differ- ent doses of metformin on bone metabolism and bone mineral density in elderly male patients with type 2 diabetes. METHODS： 102 untreated elderly male patients with type 2 diabetes were randomly divided into 3 groups. 3 groups were given low doses of met- formin group （ 1 g/d, n = 34 ） , medium doses of metformin group （1.5 g/d, n = 34） and high doses of metformin group （2 g/d, n = 34）. Phase of treatment lasted for 3 months. The levels of bone mineral density （BMD） of lumbar L24 and the femoral neck, serum bone specific alkaline phosphatase （BAP）, blood gla protein （BGP）, Tartrate Resistant Acid Phosphatase （ TRACP ）, osteoprotegrin （ OPG ）, fasting blood glucose （FBG） and hemoglobin A1C （ HbA1 C） were measured before treatment, 1 month and 3 months after administration. RESULTS ： The levels of FBP and HbA1C in 3 groups were de- creased significantly after treatment （ P 〈 0.05 ）, but there was not significant difference among 3 groups （P 〉 0.05 ）. The indicators of bone metabo- lism TRACP and OPG in 3 groups reflected no sig- nificant change before and after treatment （P 〉 0.05） ; BGP and BAP which reflected indicators of bone turnover and formation were increased after treatment, there was significant difference among 3 groups （P 〈 0.05 ）. The levels of BGP and BAP in the medium doses and the high doses of metformin groups was higher than counterpart in low doses of metformin group （ P 〈 0.05 ）, there were significant differences among groups. But the levels of BGP and BAP in the medium and high doses of metformin group were not obvious difference over the same pe- riod （P 〉 0.05 ）. After 12 weeks of treatment, the levels of BMD in 3 groups were increased, there was statistical significance among groups （ P 〈 0.05 ）. The levels of BMD in the medium doses and the high doses of metformin groups was higher than counter- part in low doses of metformin group （P 〈 0.05 ）, there were sign
作者
史德军
刘义
SHI Dejun;LIU Yi(The Second Hospital of Yinzhou, Ningbo 315100, Zhejiang, China;Guangdong Key Laboratory of Natural Medicine Research and Development, Guangdong Medical University, Zhanjiang 524025, Guangdong, China)
出处
《中国临床药理学与治疗学》
CAS
CSCD
2017年第9期1045-1049,共5页
Chinese Journal of Clinical Pharmacology and Therapeutics
基金
广东省科技攻关项目(2011B06030032)
关键词
二甲双胍
2型糖尿病
骨特异性碱性磷酸酶
抗酒石酸酸性磷酸酶
骨密度
metformin
type 2 diabetes
bonespecific alkaline phosphatase
tartrate resistant acidphosphatase
bone mineral density
