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二甲双胍治疗老年2型糖尿病合并肌少症的临床观察
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| 篇名： | 二甲双胍治疗老年2型糖尿病合并肌少症的临床观察 |
| TITLE： | Clinical observation of metformin in the treatment of diabetes mellitus type 2 complicated with sarcopenia in elderly patients |
| 摘要： | 目的 探讨二甲双胍治疗老年2型糖尿病（T2DM）合并肌少症患者的疗效及安全性。方法选择2022年1月至2024年1月于重庆医药高等专科学校附属第一医院治疗的老年T2DM合并肌少症患者，按随机数字表法分为对照组（70例）和观察组（70例）。在常规干预的基础上，对照组患者于睡前皮下注射甘精胰岛素注射液+每日早、中、晚餐前30min皮下注射人胰岛素注射液；观察组患者在对照组的基础上口服盐酸二甲双胍缓释片0.5g，每日1次。两组患者均连续治疗24周。比较两组患者糖代谢指标[空腹血糖（FBG）、餐后2h血糖（2hBG）、糖化血红蛋白（HbA1c）]、胰岛素抵抗指数（HOMA-IR）、四肢骨骼肌指数（ASMI）、握力、步行速度、脂代谢指标[血清总甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）]、血清学标志物[超敏C反应蛋白（hs-CRP）、白细胞介素6（IL-6）、铁蛋白水平]及生活质量，并记录不良反应发生情况。结果对照组和观察组分别有65、63例患者完成本研究。治疗后，两组患者FBG、2hBG、HbA1c、HOMA-IR、TG、TC及观察组患者的hs-CRP、IL-6、铁蛋白水平均较治疗前显著降低（P＜0.05），且观察组患者的HOMA-IR显著低于对照组（P＜0.05）；观察组患者的握力、步行速度、活动能力和日常生活情况指数均较治疗前及对照组显著增加（P＜0.05）。两组患者的不良反应发生率均为2.86%。结论二甲双胍可降低老年T2DM合并肌少症患者的炎症因子及血清铁蛋白水平，促进肌肉质量和力量的恢复，改善胰岛素抵抗，提高患者生活质量，且未增加不良反应的发生。 |
| ABSTRACT： | OBJECTIVE To investigate the efficacy and safety of metformin in the treatment of diabetes mellitus type 2 （T2DM） complicated with sarcopenia in elderly patients. METHODS From January 2022 to January 2024， clinical data from eligible patients with T2DM complicated with sarcopenia treated at the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College were collected. Patients were randomly assigned into control group （70 cases） and observation group （70 cases） using a random number table. Both groups received routine interventions； control group additionally received subcutaneous injections of Insulin glargine injection before bedtime and Human insulin injection 30 minutes before breakfast， lunch and dinner every day. In addition to the same treatments as the control group， the observation group was administered 0.5 g of Metformin hydrochloride sustained-release tablets orally once daily. Both groups were treated continuously for 24 weeks. Comparisons were made between the two groups in terms of glucose metabolism indexes [fasting blood glucose （FBG）， 2 h postprandial blood glucose （2 hBG）， and glycosylated hemoglobin （HbA1c）]， homeostasis model assessment of insulin resistance （HOMA-IR）， appendicular skeletal mass muscle index （ASMI）， grip strength， walking speed， lipid metabolism indexes [serum total triglyceride （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C）]， serological markers [high-sensitivity C reactive protein （hs-CRP）， interleukin-6 （IL-6）， and ferritin levels] and quality of life. The occurrence of ADR was recorded in both groups. RESULTS 65 patients in the control group and 63 patients in the observation group completed this study， respectively. After treatment， the levels of FBG， 2 hBG， HbA1c， HOMA-IR，TG and TC in both groups， and the levels of hs-CRP， IL-6 and ferritin in observation group were all significantly reduced compared to those before treatment （P＜0.05）， and the HOMA-IR in observation group was significantly lower than control group （P＜0.05）； additionally， the grip strength， walking speed， and scores for daily living and activity abilities of observation group were increased than those before treatment and the control group （P＜0.05）. The incidence of adverse drug reactions in both groups was 2.86%. CONCLUSIONS Metformin can reduce inflammatory factors and ferritin levels， promote the recovery of muscle mass and strength， improve insulin resistance， and quality of life in elderly patients with T2DM complicated with sarcopenia， and does not increase the occurrence of adverse drug reactions. |
| 期刊： | 2025年第36卷第06期 |
| 作者： | 钟雪梅；陈敏；凌雅韵；张兵钱 |
| AUTHORS： | ZHONG Xuemei，CHEN Min，LING Yayun，ZHANG Bingqian |
| 关键字： | 二甲双胍；2型糖尿病；肌少症；老年；安全性 |
| KEYWORDS： | metformin； diabetes mellitus type 2； sarcopenia； elderly； safety |
| 阅读数： | 7 次 |
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