Effects of Metformin on the Regulation of Free Fatty Acids in Insulin Resistance: A Double-Blind, Placebo-Controlled Study
Effects of Metformin on the Regulation of Free Fatty Acids in Insulin Resistance: A Double-Blind, Placebo-Controlled Study
复制标题
DOI：
10.1155/2012/394623
复制
发表时间：
2012-01-01
影响因子：
2.2
通讯作者：
Klop, Boudewijn
中科院分区：
文献类型：
--
作者：
Cabezas, Manuel Castro;van Wijk, Jeroen P. H.;Klop, Boudewijn
导论.游离脂肪酸（FFA）代谢受损与胰岛素抵抗密切相关。我们的目的是评估二甲双胍改善胰岛素敏感性后，生理状态下胰岛素抵抗患者血浆FFA的变化。方法.在胰岛素抵抗患者中进行了双盲、安慰剂对照二甲双胍干预。19例患者随机接受二甲双胍850 mg b.i.d.治疗。6周或安慰剂。参与者在治疗前后进行了精神压力测试和口服葡萄糖耐量试验（OGTT）。结果二甲双胍治疗后，空腹血糖、FFA和HOMA-IR趋于下降，表明胰岛素敏感性改善。精神应激试验期间的FFA浓度在二甲双胍后显示出类似的模式，尽管在所有时间点均低于安慰剂组。空腹血浆游离脂肪酸的降低与HbA 1c（r = 0.70; P = 0.03）和空腹血糖（r = 0.74; P = 0.01）的降低呈正相关。二甲双胍或安慰剂对OGTT期间血浆FFA的抑制没有改变。结论尽管胰岛素敏感性有改善的趋势，但胰岛素抵抗中的二甲双胍并没有导致FFA动力学的改善。二甲双胍很可能主要通过抑制空腹FFA浓度而不是通过抑制急性应激诱导的脂解来降低血浆FFA。
Introduction. Impaired free fatty acid (FFA) metabolism is closely linked to insulin resistance. Our aim was to evaluate plasma FFA changes in insulin resistance in a physiological situation after improvement of insulin sensitivity bymetformin. Methods. A doubleblind, placebo-controlled intervention with metformin was carried out in patients with insulin resistance. Nineteen patients were randomized to receive metformin 850 mg b.i.d. during 6 weeks or placebo. Participants underwent a mental stress test and an oral glucose tolerance test (OGTT) before and after treatment. Results. Fasting plasma glucose, FFA, and HOMA-IR tended to decrease after metformin, suggesting improved insulin sensitivity. FFA concentrations during the mental stress test showed a similar pattern after metformin, albeit lower at all time points, in contrast to the placebo group. The decrease in fasting plasma FFAs was positively associated to the decrease in HbA1c (r = 0.70; P = 0.03) and in fasting glucose (r = 0.74; P = 0.01). The suppression of plasma FFAs during OGTT did not change bymetformin or placebo. Conclusion. Metformin in insulin resistance did not lead to improved FFA dynamics despite a trend of improved insulin sensitivity. Metformin most likely decreases plasma FFAs mainly by suppressing fasting FFA concentrations and not by suppression of acute stress-induced lipolysis.