A combination of metformin and insulin improve cardiovascular and cerebrovascular risk factors in individuals with type 1 diabetes mellitus
A combination of metformin and insulin improve cardiovascular and cerebrovascular risk factors in individuals with type 1 diabetes mellitus
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二甲双胍和胰岛素组合可改善 1 型糖尿病患者的心脑血管危险因素
DOI：
10.1016/j.diabres.2022.110073
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发表时间：
2022-09-08
影响因子：
5.1
通讯作者：
Song，Wei
中科院分区：
文献类型：
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作者：
Xu，Linlin;Wang，Wei;Song，Wei
本研究旨在进一步阐明在胰岛素治疗中加入二甲双胍是否能改善T1DM患者的心脑血管危险因素。方法在电子数据库中检索随机对照试验，比较二甲双胍与安慰剂对T1DM患者心脑血管疾病危险因素的疗效和安全性，并进行meta分析。结果共纳入13项心血管研究。二甲双胍组患者颈动脉内膜中膜平均厚度显著降低0.03 mm，升主动脉脉波速度显著降低6.3 m/s，降主动脉壁剪切应力显著降低1.77 dyn/cm2(P = 0.02)，胰岛素日剂量显著降低0.05 U/kg/d，体重显著降低2.27 kg，无脂质量显著降低1.32 kg，体重指数显著降低0.58 kg/m2，臀围显著降低0.29 m，低密度脂蛋白显著降低0.16 mmol/L，均P < 0.05。二甲双胍组大鼠血流介导舒张率提高1.29%，葡萄糖输注率/胰岛素输注率提高18.22 mg/(kg⋅min)/μIU/μL，腰臀比提高0.02,P < 0.00001。二甲双胍组在血压、反应性充血指数、腰围、甘油三酯、总胆固醇、高密度脂蛋白胆固醇或体重指数Z评分方面均无差异。用于脑血管研究。但他们都没有进行风险因素评估。结论二甲双胍可通过非降糖多途径改善T1DM患者心脑血管危险因素。
BackgroundThis study aims to further clarify whether the addition of metformin to insulin treatment improve cardiovascular and cerebrovascular risk factors in individuals with T1DM.MethodsElectronic databases were searched for randomized controlled trials in which the efficacy and safety of metformin were compared with those of a placebo for risk factors of cardiovascular and cerebrovascular disease among individuals with T1DM, and a meta-analysis was conducted.ResultsThirteen cardiovascular studies were identified. In the metformin group, mean carotid intimal media thickness was significantly reduced by 0.03 mm, ascending aortic pulse wave velocity by 6.3 m/s, descending aortic wall shear stress by 1.77 dyn/cm2(P = 0.02), insulin daily dose by 0.05 U/kg/d, body weight by 2.27 kg, fat-free mass by 1.32 kg, body mass index by 0.58 kg/m2, hip circumference by 0.29 m, and low-density lipoprotein by 0.16 mmol/L, all above are P < 0.05. In the metformin group, flow-mediated dilation was increased by 1.29 %, glucose infusion rate/insulin by 18.22 mg/(kg⋅min)/μIU/μL, and waist-to-hip ratio by 0.02, all above are P < 0.00001. The metformin group showed no differences in blood pressure, reactive hyperemia index, waist circumference, triglyceride, total cholesterol, high-density lipoprotein cholesterol, or body mass index Z score. For cerebrovascular studies were identified. But none of them had a risk factor assessment.ConclusionsMetformin can ameliorate cardiovascular and cerebrovascular risk factors through non-hypoglycemic multiple pathways in individuals with T1DM.