The Influence Of Metformin On Patients With Newly Diagnosed Type 2 Diabetes' Hcy And IMT

Objective:To observe the changes of blood lipid, glycolated hemoglobin (HbAlc), plasma homocysteine (Hcy) and the carotid artery intima media thickness(IMT) in newly diagnosed patients with type 2 diabetes mellitus(T2DM) before and after one year therapy of metfiormin, and analyse the relationship between IMT and the variables. To explore the role of Hcy and IMT in diabetic macroangiopathy and metformin could attenuate the progression of macrovascular lesions in T2DM.Method:Newly diagnosed T2DM patients with 30 cases aged 53.2±12.3 years, healthy volunteers with 20 cases aged 43.7±9.8 years respectively, as T2DM group and normal control group. Patients with those disease such as acute or chronic infectious disease,stress state,hepatic and renal disease,coronary disease,cranial vascular disease were eliminated. Moreover we further excluded patients who were treated with lipid-lower drugs in three months. And compared the differences of plasma glucose,blood lipid,HbAlc,BMI,Hcy,IMT between T2DM group and the normal control group. All the participants of T2DM were administered 1500 mg of metformin daily in addition to rational diet and proper exercises, we tested HbAlc and plasma glucose every three months the patients whose HbAlc>8.0% were given acarbose three times daily. Who did not reach the targets were also excluded. Each index was detected after one year therapy. Biochemical indicators TG,TC,HDL-C,LDL-C and Hcy were detected by automatic biochemistry analyzer; HbAlc was measured by high-performance liquid chromatography; IMT of common carotid artery (CCA) was measured with highresolution B-mode ultrasonography by the same physician. Changes of all the index were detected before and after metformin treatment. Multivariate linear regression analysis was also used to analyse the relationship between Hcy and IMT.Result:(1) Compared with subjects of control group, SBP,TG,TC,LDL-C, HbAlc,FPG,2hPG,Hcy and IMT in T2DM group were increased significantly (p<0.05 or p<0.01) in T2DM and relatively lower levels of HDL-C (P<0.05).(2) After one year metformin treatment FPG,2hPG,HbAlc,blood lipid. Hcy and IMT in T2DM group were significantly lower than before (P<0.05 or P<0.01), HDL-C were higher than before, but the difference were not statistical significance. SBP and DBP were not statistical significance before and after.(3) Multiple stepwise linear regression analysis showed TC(R=0.468, P<0.05), LDL-C(R=0.657, P<0.01) and Hcy(R=0.481, P<0.05) had positive correlated with IMT.Age,TG,BMI,FPG and HbAlc did not reach the statistical significance.Conclusions:(1) The study found that, TG,TC,LDL-C,Hcy,IMT were significant higher in patients with T2DM than the normal control group, showed Lipid and amino acid metabolic disorder had appeared in the newly diagnosed patients of T2DM. Vascular injury were also found in this period.(2) Metformin can reduce FPG,2hPG,HbAlc,blood lipid. Hcy and IMT levels and improve the body lipid and amino acid metabolism with T2DM.(3) Early use metformin for patients of type 2 diabetes can also reduce Hcy and postpone the develop of atherosclerosis.