Metformin combined with glucocorticoid in the treatment of SLE patients with IGT
10.12092/j.issn.1009-2501.2020.06.010
- VernacularTitle: 二甲双胍联合糖皮质激素治疗伴糖耐量异常的系统性红斑狼疮患者的临床研究
- Author:
Guinv LI
1
Author Information
1. Department of Pharmacy, The First Affiliated Hospital of Hainan Medical College
- Publication Type:Journal Article
- Keywords:
Impaired glucose tolerance;
Islet function;
Metformin;
Systemic lupus erythematosus;
Th17/Treg cells
- From:
Chinese Journal of Clinical Pharmacology and Therapeutics
2020;25(6):670-676
- CountryChina
- Language:Chinese
-
Abstract:
AIM: To investigate the clinical curative effect of metformin combined with glucocorticoids in the treatment of patients with systemic lupus erythematosus (SLE) complicated with impaired glucose tolerance (IGT) and the effect on islet function and Th17/Treg cell imbalance. METHODS: Eighty-four patients with SLE complicated with IGT were randomly divided into the combined group and the control group with 42 cases in each group. All of them were given life and diet guidance. The control group was treated with glucocorticoids while the combined group was treated with metformin combined with glucocorticoids. One month later, the curative effect was observed, and islet function and Th17/Treg cell imbalance were evaluated. RESULTS: The total response rate of the combined group was significantly higher than that of the control group (90.48% vs. 71.43%, P<0.05). The SLE activity index score and the erythrocyte sedimentation rate (ESR) [(2.6±0.3) points, (18±4) mm/h] were significantly lower than those in the control group [(3.9±0.8) points, (23±4) mm/h] (P<0.05). Fasting blood glucose (FBG), fasting insulin (Fins), steady-state model-insulin resistance index (HOMA-IR) and islet β-functioning cell index (HOMA-β) in the combined group were significantly improved after treatment (P<0.05). There were statistically significant differences between the two groups (P<0.05). The proportion of NGT in the combined group was significantly higher than that in the control group (73.81% vs. 30.95%, P<0.05). The ratios of Th17 and Treg cells in the combined group were (6.2±0.9) /μL and (31±7) /μL, and Th17/Treg was (0.20±0.05). Compared with the control group [(7.4±1.3) /μL, (28±7) /μL, (0.26±0.06)], there were statistically significant differences (P<0.05). The SLE activity index scores after treatment were significantly correlated with HOMA-IR, HOMA-β and Th17 cells, Treg cells, Th17/Treg (P<0.05). Besides, HOMA-IR and HOMA-β were significantly correlated with Th17 cells, Treg cells and Th17/Treg (P<0.05). The adverse reactions in both groups were mild, and there was no statistically significant difference in the incidence (P>0.05). CONCLUSION: Metformin combined with glucocorticoids is effective in the treatment of SLE with IGT. The treatment can control disease activity, lower blood glucose levels, improve islet function and correct Th17/Treg cell imbalance with high safety.
