Metformin yatulukira zatsopano

1. Amayembekezereka kukonza ngozi zakufa kwa impso ndi kufa ndi matenda a impso
Gulu lokhutira la WuXi AppTec Medical New Vision yatulutsa nkhani kuti kafukufuku wa anthu 10,000 adawonetsa kuti metformin itha kubweretsa chiopsezo cha impso kulephera ndi kufa ndi matenda a impso.

Kafukufuku wofalitsidwa mu nyuzipepala ya American Diabetes Association (ADA) "Chisamaliro cha Shuga" (Chisamaliro cha Matenda a shuga) adawonetsa kuti mankhwala ndi kuwunika kwa anthu opitilira 10,000 zidawonetsa kuti odwala matenda ashuga amtundu wa 2 omwe amatenga matenda a impso (CKD) amatenga Metformin imalumikizidwa ndi Kuchepetsa chiopsezo chaimfa ndi matenda a impso (ESRD), ndipo sikuwonjezera chiopsezo cha lactic acidosis.

Matenda a impso ndi vuto lodziwika bwino la matenda ashuga. Poganizira kuti odwala omwe ali ndi matenda a impso ochepa amatha kupatsidwa metformin, gulu lofufuzira lidasanthula odwala 2704 m'magulu awiriwa omwe amatenga metformin osatenga metformin.

Zotsatirazo zikuwonetsa kuti poyerekeza ndi omwe sanatenge metformin, odwala omwe adatenga metformin adachepetsa 35% pachiwopsezo chaimfa ndi kuchepa kwa 33% pachiwopsezo chopita kumapeto kwa matenda a impso. Mapindu awa adawonekera pang'onopang'ono patatha pafupifupi zaka 2.5 atatenga metformin.

Malinga ndi malipoti, m'zaka zaposachedwa, malangizo a US FDA amalimbikitsa kupumula kugwiritsa ntchito metformin mwa odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi matenda a impso, koma odwala omwe ali ndi matenda a impso ochepa. Kwa odwala omwe ali ndi gawo lochepa (3B) komanso matenda a impso oopsa, kugwiritsa ntchito metformin kumatsutsanabe.

Katherine R. Tuttle, pulofesa wa pa yunivesite ya Washington ku United States, anati: “Zotsatira za kafukufukuyu n'zolimbikitsa. Ngakhale odwala omwe ali ndi matenda a impso oopsa, chiopsezo cha lactic acidosis ndi chotsika kwambiri. Kwa odwala omwe ali ndi matenda a shuga a mtundu wachiwiri komanso matenda a impso, metformin ikhoza kukhala njira yodzitetezera ku imfa komanso Mankhwala ofunikira a impso, koma popeza uku ndikuwunika mobwerezabwereza ndikuwunika, zotsatira zake ziyenera kumasuliridwa mosamala. ”

2. Zithandizo zochiritsira zosiyanasiyana zamatsenga mankhwala metformin
Metformin titha kunena kuti ndi mankhwala akale omwe akhala kwanthawi yayitali. Pakufufuza kwamankhwala osokoneza bongo, mu 1957, wasayansi waku France Stern adafalitsa zotsatira zake ndikuwonjezera chotsitsa cha lilac chomwe chimagwiritsa ntchito hypoglycemic mu nyemba za mbuzi. Alkali, wotchedwa metformin, Glucophage, zomwe zikutanthauza kudya shuga.

Mu 1994, metformin idavomerezedwa ndi US FDA kuti igwiritsidwe ntchito mu mtundu wachiwiri wa shuga. Metformin, monga mankhwala ovomerezeka ochizira matenda ashuga amtundu wa 2, amalembedwa ngati mankhwala oyamba a hypoglycemic pamankhwala osiyanasiyana kunyumba ndi kunja. Ili ndi maubwino olondola a hypoglycemic, chiopsezo chochepa cha hypoglycemia, ndi mtengo wotsika. Pakali pano ndi mankhwala omwe amagwiritsidwa ntchito kwambiri Mmodzi mwa gulu la mankhwala osokoneza bongo.

Monga mankhwala omwe ayesedwa kwa nthawi yayitali, akuti pali oposa 120 miliyoni ogwiritsa ntchito metformin padziko lonse lapansi.

Ndikukula kwa kafukufuku, mphamvu zochiritsira za metformin zakula mosalekeza. Kuphatikiza pazomwe zapezedwa posachedwa, metformin yapezeka kuti ili ndi zotsatira pafupifupi 20.

1. Zotsutsa-kukalamba
Pakadali pano, US Food and Drug Administration idavomereza kuyesedwa kwachipatala kwa "kugwiritsa ntchito metformin polimbana ndi ukalamba". Chifukwa chomwe asayansi akunja amagwiritsa ntchito metformin ngati mankhwala osagwirizana ndi ukalamba mwina chifukwa chakuti metformin imatha kuwonjezera kuchuluka kwama molekyulu a oxygen omwe amatulutsidwa m'maselo. Koposa zonse, izi zikuwoneka kuti zimapangitsa thupi kukhala lolimba komanso kutalikitsa moyo.

2. Kuchepetsa thupi
Metformin ndi hypoglycemic wothandizila amene akhoza kuonda. Itha kukulitsa chidwi cha insulin ndikuchepetsa kaphatikizidwe wamafuta. Kwa okonda shuga ambiri amtundu wa 2, kuchepa thupi ndi chinthu chomwe chimathandiza kuti anthu azikhala ndi shuga wathanzi.

Kafukufuku wopangidwa ndi gulu lofufuzira la United States Diabetes Prevention Program (DPP) adawonetsa kuti munthawi yophunzira yopanda malire ya zaka 7-8, odwala omwe adalandira chithandizo cha metformin adataya pafupifupi 3.1 kg kulemera.

3. Kuchepetsa chiopsezo chotenga padera komanso kubereka msanga kwa amayi ena apakati
Kafukufuku waposachedwa wofalitsidwa ku The Lancet akuwonetsa kuti metformin imachepetsa chiopsezo chotenga padera komanso kubereka msanga kwa amayi ena apakati.

Malinga ndi malipoti, asayansi aku Norwegian University of Science and Technology (NTNU) ndi Chipatala cha St. Olavs adachita kafukufuku wazaka pafupifupi 20 ndipo adapeza kuti odwala omwe ali ndi polycystic ovary syndrome omwe amatenga metformin kumapeto kwa miyezi itatu ya mimba atha kuchepa- term padera ndi padera. Kuopsa kobadwa msanga.

4. Pewani kutupa komwe kumayambitsidwa ndi utsi
Zotsatira za kafukufukuyu zikuwonetsa kuti gulu lotsogozedwa ndi Pulofesa Scott Budinger waku Northwestern University adatsimikizira mbewa kuti metformin imatha kuteteza kutupa komwe kumayambitsidwa ndi utsi, kuteteza ma cell a chitetezo kutulutsa molekyulu yoopsa kulowa m'magazi, kulepheretsa mapangidwe a thrombosis, motero kuchepetsa mtima dongosolo. Kuopsa kwa matenda.

5. Kuteteza mtima
Metformin imakhala ndi zoteteza pamtima ndipo pakadali pano ndi mankhwala okhawo omwe hypoglycemic amalimbikitsidwa ndi malangizo a matenda ashuga kukhala ndi umboni wowoneka bwino wamaphunziro amtima. Kafukufuku akuwonetsa kuti chithandizo chanthawi yayitali cha metformin chimakhudzana kwambiri ndi kuchepa kwa chiwopsezo cha matenda amtima mwa omwe ali ndi matenda ashuga omwe ali ndi matenda a 2 komanso omwe ali ndi matenda ashuga omwe adwala kale matenda amtima.

6. Kusintha matenda a ovary polycystic
Matenda ovuta a Polycystic ndi matenda osakanikirana omwe amadziwika ndi hyperandrogenemia, ovarian dysfunction, ndi polycystic ovary morphology. Matenda ake omwe sadziwika bwino sakudziwika bwinobwino, ndipo odwala nthawi zambiri amakhala ndi magawo osiyanasiyana a hyperinsulinemia. Kafukufuku wasonyeza kuti metformin imatha kuchepetsa kukana kwa insulin, kubwezeretsa magwiridwe antchito, komanso kukonza hyperandrogenemia.

7. Kusintha zomera m'mimba
Kafukufuku wasonyeza kuti metformin imatha kubwezeretsa kuchuluka kwa maluwa am'mimba ndikupangitsa kuti isinthe m'njira yomwe ingathandize kukhala wathanzi. Zimakhala malo opindulitsa mabakiteriya opindulitsa m'matumbo, potero amachepetsa shuga wamagazi ndikuwongolera chitetezo chamthupi.

8. Zikuyembekezeka kuthandizira ena autism
Posachedwa, ofufuza ku Yunivesite ya McGill adazindikira kuti metformin imatha kuchiza mitundu ina ya matenda a Fragile X ndi autism, ndipo kafukufukuyu wopangidwa mwatsopano adafalitsidwa munyuzipepala ya Nature Medicine, nkhani yaying'ono ya Nature. Pakadali pano, autism ndiimodzi mwazinthu zamankhwala zomwe asayansi amakhulupirira kuti zitha kuchiritsidwa ndi metformin.

9. Chosintha m'mapapo mwanga fibrosis
Ofufuza ku Yunivesite ya Alabama ku Birmingham adapeza kuti mwa odwala omwe ali ndi idiopathic pulmonary fibrosis ndi mbewa zamapapo zam'mimba zamtundu wa bleomycin, zomwe AMPK imagwiritsa ntchito m'matenda a fibrotic zimachepetsedwa, ndipo matendawo amalimbana ndi ma cell.

Kugwiritsa ntchito metformin kuyambitsa AMPK mu myofibroblasts kumatha kulimbikitsanso maselowa kuti apoptosis. Kuphatikiza apo, pamtundu wama mbewa, metformin imatha kuthamangitsa kuchotsedwa kwa minofu ya fibrotic yomwe idapangidwa kale. Kafukufukuyu akuwonetsa kuti metformin kapena agonists ena a AMPK atha kugwiritsidwa ntchito kuthana ndi fibrosis yomwe idachitika kale.

10. Thandizani kusiya kusuta
Ofufuza ku Yunivesite ya Pennsylvania apeza kuti kugwiritsa ntchito chikonga kwa nthawi yayitali kumatha kuyambitsa njira yodziwitsira ya AMPK, yomwe imalephereka pakutha kwa chikonga. Chifukwa chake, adatsimikiza kuti ngati mankhwala agwiritsidwa ntchito kuyambitsa njira yodziwitsira ya AMPK, itha kuchepetsa kuyankha kotaya.

Metformin ndi agonist wa AMPK. Ofufuzawa atapereka metformin kwa mbewa zomwe zidachotsedwa mu chikonga, adapeza kuti zathandizira kuchotsa kwa mbewa. Kafukufuku wawo akuwonetsa kuti metformin itha kugwiritsidwa ntchito kuthandizira kusiya kusuta.

11. Zotsutsana ndi zotupa
M'mbuyomu, kafukufuku wamankhwala am'mbuyomu komanso zamankhwala awonetsa kuti metformin imangothandiza kusintha kwamatenda osakwanira posintha magawo amthupi monga hyperglycemia, insulin kukana komanso atherosclerotic dyslipidemia, komanso imatsutsana ndi zotupa.

Kafukufuku wanena kuti metformin imatha kuletsa kutupa, makamaka kudzera mwa AMP-activated protein kinase (AMPK) -kudalira kapena kudziyimira pawokha pakulemba kwa nyukiliya B (NFB).

12. Bweretsani kuwonongeka kwazidziwitso
Ofufuza pa Yunivesite ya Texas ku Dallas apanga mbewa yomwe imatsanzira kuwonongeka kwazidziwitso zokhudzana ndi zowawa. Adagwiritsa ntchito mtunduwu kuyesa kuyesa kwa mankhwala angapo.

Zotsatira zoyesera zikuwonetsa kuti chithandizo cha mbewa ndi 200 mg / kg kulemera kwa metformin masiku asanu ndi awiri kumatha kuthana ndi vuto lakumvetsetsa komwe kumachitika chifukwa cha ululu.

Gabapentin, yemwe amachiza matenda a neuralgia ndi khunyu, alibe zotere. Izi zikutanthauza kuti metformin itha kugwiritsidwa ntchito ngati mankhwala akale kuti athetse vuto la kuzindikira kwa odwala omwe ali ndi neuralgia.

13. Chepetsani kukula kwa chotupa
Masiku angapo apitawo, malinga ndi Singularity.com, akatswiri ochokera ku European Institute of Oncology adazindikira kuti metformin ndi kusala kudya kumatha kugwira ntchito mogwirizana kuti muchepetse kukula kwa zotupa za mbewa.

Kufufuza kwina, kunapezeka kuti metformin ndi kusala kudya kumalepheretsa kukula kwa chotupa kudzera mu njira ya PP2A-GSK3β-MCL-1. Kafukufukuyu adasindikizidwa pa Cancer Cell.

14. Kodi kuteteza macular alibe
Dr. Yu-Yen Chen wochokera ku Taichung Veterans General Hospital ku Taiwan, China posachedwapa apeza kuti kuchuluka kwa kuchepa kwa makanda (AMD) kwa odwala omwe ali ndi matenda a shuga a 2 omwe amatenga metformin ndiotsika kwambiri. Izi zikuwonetsa kuti ngakhale kuwongolera matenda ashuga, ntchito zotsutsana ndi zotupa komanso antioxidant ya metformin imatha kuteteza AMD.

15. Kapena amatha kuchiza tsitsi
Gulu la Huang Jing, wasayansi waku China ku University of California, Los Angeles, adazindikira kuti mankhwala monga metformin ndi rapamycin amatha kulimbikitsa maubweya atsitsi mu mbewa yopuma kuti alowe gawo lokulitsa ndikulimbikitsa kukula kwa tsitsi. Kafukufuku wofananira adasindikizidwa munyuzipepala yotchuka ya Cell Reports.

Komanso, asayansi atagwiritsa ntchito metformin kuchiza odwala omwe ali ndi matenda a polycystic ovary ku China ndi India, awonanso kuti metformin imalumikizidwa ndi kuchepa kwa tsitsi.

16. Zosintha zaka zakubadwa
Posachedwa, tsamba lovomerezeka la magazini yapadziko lonse ya sayansi ndi ukadaulo "Nature" idasindikiza nkhani ya blockbuster. Malipoti akuwonetsa kuti kafukufuku wochepa wazachipatala ku California adawonetsa koyamba kuti ndizotheka kusintha wotchi ya epigenetic ya munthu. Chaka chatha, odzipereka asanu ndi anayi odzipereka adatenga mahomoni osakaniza ndi mankhwala awiri a shuga, kuphatikiza metformin. Kuyesedwa pofufuza zolemba pa genome ya munthu, zaka zawo zachilengedwe zatsika ndi zaka pafupifupi 2.5.

17. Mankhwala osakaniza amatha kuchiza khansa ya m'mawere yopanda katatu
Masiku angapo apitawo, gulu lotsogozedwa ndi Dr. Marsha rosner wachuma wa University of Chicago lidazindikira kuti kuphatikiza kwa metformin ndi mankhwala ena akale, heme (panhematin), atha kuthana ndi khansa ya m'mawere yopanda katatu yomwe imawopseza thanzi la amayi .

Ndipo pali umboni kuti njira yothandizirayi itha kukhala yothandiza pama khansa osiyanasiyana monga khansa yam'mapapo, khansa ya impso, khansa ya m'mimba, kansa ya Prostate komanso acute myeloid leukemia. Kafukufuku wofananira adasindikizidwa munyuzipepala yayikulu ya Nature.

18. Mutha kuchepetsa zovuta zoyipa za glucocorticoids
Posachedwa, "Lancet-Diabetes ndi Endocrinology" idasindikiza kafukufuku-zotsatira za kafukufukuyu zikuwonetsa kuti mgulu lachiwiri lakuyesa kwamankhwala, metformin yomwe imagwiritsidwa ntchito mwa odwala omwe ali ndi matenda opatsirana opitilira muyeso amatha kusintha thanzi la kagayidwe ndikuchepetsa chithandizo cha glucocorticoid Zovuta zoyipa.

Kafukufuku wanena kuti metformin itha kugwiritsa ntchito puloteni yayikulu ya AMPK, ndipo momwe amagwirira ntchito ndi chimodzimodzi ndi glucocorticoids, ndipo amatha kuthana ndi zovuta zoyambitsidwa ndi kugwiritsa ntchito kwambiri glucocorticoids.

19. Tikuyembekeza kuchiza matenda ofoola ziwalo
M'mbuyomu, gulu lofufuza lotsogozedwa ndi a Robin JM Franklin aku University of Cambridge ndi wophunzira wake Peter van Wijngaarden adasindikiza nkhani munyuzipepala yotchuka ya "Cell Stem Cells" kuti apeza mtundu winawake wamaselo okalamba amitsempha omwe amatha kuchira atachiritsidwa ndi metformin. Poyankha kumasulira komwe kumalimbikitsa kusiyanitsa, imawonekeranso mwamphamvu paunyamata ndikupititsa patsogolo kukonzanso kwa mitsempha myelin.

Kupeza kumeneku kumatanthauza kuti metformin ikuyembekezeka kugwiritsidwa ntchito pochiza matenda osasinthika okhudzana ndi neurodegeneration, monga multiple sclerosis.


Post nthawi: Apr-21-2021