Gender-dependent Effects of Metformin on Vaspin and Adiponectin in Type 2 Diabetes Patients: A Randomized Clinical Trial
Gender-dependent Effects of Metformin on Vaspin and Adiponectin in Type 2 Diabetes Patients: A Randomized Clinical Trial
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DOI：
10.1055/s-0032-1330008
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发表时间：
2013-04-01
影响因子：
2.2
通讯作者：
Nakhjavani, M.
中科院分区：
文献类型：
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作者：
Esteghamati, A.;Mousavizadeh, M.;Nakhjavani, M.
本研究的目的是评估二甲双胍对糖尿病患者血清vaspin和脂联素浓度的影响。对99例新诊断的、未经药物治疗的2型糖尿病患者（NCT 01521624）进行了随机临床试验。患者被随机分配至二甲双胍1000 mg/d+建议运动和生活方式改变组（n = 50）或单独改变组（n = 49）。第三组50名血糖正常的受试者也被招募，以比较健康和糖尿病受试者之间的脂肪因子浓度。采用酶联免疫吸附法（ELISA）测定治疗前和治疗12周后血清脂肪因子浓度。健康受试者的脂联素水平显著较高，但血清vaspin浓度较低（所有病例均为p <0.001）。与男性相比，女性的Vaspin和脂联素浓度分别高出23%和26%。仅在女性中，二甲双胍治疗3个月后Vaspin显著下降（女性中为1.36 vs. 0.98，p = 0.003，男性中为1.31 vs. 1.20，p = 0.335）。二甲双胍治疗没有改变病例组中女性和男性的脂联素浓度（女性12.66 vs. 12.44 p = 0.699，男性10.13 vs. 10.94 p = 0.253）。比较病例组和对照组，在最终的多变量模型中，在仅控制女性（p = 0.002）而非男性（p = 0.896）的潜在混杂因素后，二甲双胍比生活方式改变更显著地降低了vaspin水平。相反，对照组的脂联素水平增加更显著，同样仅在女性中（女性和男性分别为p = 0.012和0.579）。我们的研究结果表明，二甲双胍治疗以性别特异性方式降低vaspin浓度。二甲双胍在增加糖尿病患者的脂联素水平方面几乎没有益处。
The aim of the study was to assess the effects of metformin on serum concentrations of vaspin and adiponectin in diabetes. Randomized clinical trial of 99 newly diagnosed, medication-nave, type 2 diabetes patients (NCT01521624) was carried out. Patients were randomly assigned to either metformin 1 000 mg daily plus advice for exercise and lifestyle modification (n = 50) or modification alone (n = 49). A third group of 50 normoglycemic subjects were also enrolled to compare adipokine concentrations between healthy and diabetes subjects. Serum concentrations of adipokines were measured at baseline and after 12 weeks using ELISA method. Healthy subjects had significantly higher adiponectin levels, but lower concentrations of serum vaspin (p < 0.001 in all cases). Vaspin and adiponectin concentrations were 23% and 26% higher in women compared with men. Vaspin dropped significantly after 3-month metformin therapy only in women (1.36 vs. 0.98, p = 0.003 in women and 1.31 vs. 1.20, p = 0.335 in men). Metformin therapy did not change adiponectin concentration in neither women nor men of the case group (12.66 vs. 12.44 p = 0.699 in women and 10.13 vs. 10.94 p = 0.253 in men). Comparing case and control groups, metformin decreased vaspin levels more significantly than lifestyle modification in the final multivariate model after controlling for potential confounders only in women (p = 0.002) but not men (p = 0.896). Conversely, adiponectin levels increased more significantly in the control group, again only in women (p = 0.012 and 0.579 for women and men, respectively). Our findings suggest that metformin therapy reduces vaspin concentration in a gender-specific manner. Metformin exerts little benefit in increasing adiponectin levels in diabetes patients.