Research On The Correlation Of Metformin In Treating Atherosclerosis Of Impaired Glucose Tolerance Patients

Objective： This study is to investigate the role of metformin in treat theatherosclerosis(AS) in patients with impaired glucose tolerance（IGT）, to analysis therelationship the atherogenic index of plasma (AIP) and the serum high sensitivityC-reactive protein (hs-CRP) with atherosclerosis. This study also to observe thedifferent levels of blood sugar, blood lipids, plasma atherogenic atherosclerosis indexand high sensitivity Creactive protein after using different doses of metformin, toinvestigate the clinical significance of metformin in lipid-lowering, anti-inflammatory,and to provide a theoretical basis for optimize the early intervention programs for theatherosclerosis in patients with impaired glucose tolerance.Methods:120patients who was diagnosed impaired glucose tolerance (IGT) with thediagnostic criteria for diabetes based on the1999WHO, selected in the FirstPeople’s Hospital of Jining City from September2010to October2011. These120IGT patients according to OGTT experimental results were randomly divided intothree groups with random-table method:(1) conventional-dose metformin group,40patients (18males,22females), age (45.10±8.09);(2) small dose of metformingroup,40cases (male17cases,23female), age (44.28±8.54);③control group,40patients (15males,25female), age (45.20±8.36). These three groups were given thesame diabetes education to guide the patients have the same guidance diet, exercise,diet, exercise therapy, give the patients with impaired glucose tolerance ofconventional-dose metformin group500mg metformin tid, and give the patients withimpaired glucose tolerance of small-dose metformin group250mg metformin tidotherwise. The whole study will be followed up3months. In the beginning the basicclinical data of all subjects such as to age, height, weight, blood pressure andbiochemical parameters such as fasting plasma glucose(FPG), postprandial bloodsugar(PBG), triglycerides(TG), total cholesterin(TC), HDL, LDL, glycatedhemoglobin(HbA1c), hs-CRP need to be collected, and calculated the atherogenicindex of plasma (AIP); the same blood specimens of high sensitivity C-reactionprotein (hs-CRP) were tested by ELISA.2; After treating with the methods above-mentioned for3months, the blood lipids, blood glucose, AIP and of hs-CRPneed to be collected and calculated again.Results:1. All the patients’ age, BMI, blood pressure, and the biochemical parametersin the beginning of the experiment such as HbA1c, FBG, PBG, TG, TC, HDL, LDL,AIP and hs-CRP was no significant difference.2. The comparison of the level of theindicators:(1) After3months of treatment, the FBG of conventional-dose metformingroup, small dose metformin group and control group have no statistical senses(P>0.05) than before treatment, the change between before and after were comparedwith each other have no statistical significant (P>0.05);(2) After3months oftreatment, the PBG of conventional-dose metformin group, small dose metformingroup have statistical senses (P>0.05) than before treatment, the PBG of controlgroup have no statistical senses (P<0.05) than before treatment, the change betweenbefore and after were compared with each other have statistical significant (P<0.05);(3) After3months of treatment, the TG、TC、HDL、LDL、AIP、hs-CRP ofconventional-dose metformin group, small dose metformin group have statisticalsenses (P<0.05) than before treatment, the TG、TC、HDL、LDL、AIP、hs-CRP ofcontrol group have no statistical senses (P<0.05) than before treatment, the change ofconventional-dose metformin group and small-dose metformin group between beforeand after were compared have no statistical significant (P>0.05), the change ofconventional-dose metformin group vs control group between and small-dosemetformin group vs control group before and after were compared have statisticalsignificant (P<0.05).3. The correlation between hs-CRP level and AIP: the result ofcorrelation analysis of the change of AIP vs hs-CRP between before and after showsthat both showed a significant positive correlation, the Pearson correlation coefficientwas0.773(P<0.01).Conclusions:1. Metformin can significantly reduce the higher PBG than normal inpatients with impaired glucose tolerance, without reducing the normal FPG level, andthe change of blood glucose is related to the metformin’s dose.2. Metformin caneffectually intervene the lipid AIP and CRP, and there is not obvious correlationbetween the dose of metformin and the effective of metformin to intervene lipids AIP and hs-CRP.3. AIP has positive correlation with hs-CRP.