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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                                                           Δ



          钟雪梅    1, 2* ,陈 敏 ,凌雅韵 ,张兵钱(1. 重庆医药高等专科学校临床医学院呼吸内分泌教研室,重庆
                            3 #
                                      1
                                              1
          401331;2.重庆医药高等专科学校附属第一医院内分泌科,重庆 400060;3.川北医学院附属医院内分泌科,
          四川 南充 637000)

          中图分类号  R969.4      文献标志码  A      文章编号  1001-0408(2025)06-0732-05
          DOI  10.6039/j.issn.1001-0408.2025.06.16

          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 30 min 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0.5 g,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2 h血糖(2 hBG)、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、2 hBG、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。
          关键词  二甲双胍;2型糖尿病;肌少症;老年;安全性

          Clinical observation of metformin in the treatment of diabetes mellitus type 2 complicated with sarcopenia
          in elderly patients
                                                   1
                                                                     1
                         1, 2
          ZHONG Xuemei ,CHEN Min ,LING Yayun ,ZHANG Bingqian(1.  Respiratory  and  Endocrinology  Teaching
                                      3
          and  Research  Section,  Clinical  Medical  College,  Chongqing  Medical  and  Pharmaceutical  College,  Chongqing
          401331,  China;2.  Dept.  of  Endocrinology,  the  First  Affiliated  Hospital  of  Chongqing  Medical  and  Pharmaceutical
          College,  Chongqing  400060,  China;3.  Dept.  of  Endocrinology,  the  Affiliated  Hospital  of  North  Sichuan
          Medical College, Sichuan Nanchong 637000, China)

          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
              Δ 基金项目 重庆市科卫联合医学科研项目(No. 2024MSXM059)           65  patients  in  the  control  group  and  63  patients  in  the
             *第一作者 主治医师,讲师,硕士。研究方向:内分泌基础与临
                                                              observation  group  completed  this  study,  respectively.  After
          床。E-mail:ZJN_safjs@163.com
              # 通信作者 副主任医师,硕士。研究方向:内分泌基础与临床。                  treatment,  the  levels  of  FBG,  2  hBG,  HbA1c,  HOMA-IR,
          E-mail:chenmin1972@sina.com                         TG  and  TC  in  both  groups,  and  the  levels  of  hs-CRP,  IL-6


          · 732 ·    China Pharmacy  2025 Vol. 36  No. 6                               中国药房  2025年第36卷第6期
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