Effect of oral metformin on postoperative recurrence of type 2 diabetes mellitus with colorectal adenoma

doi:10.3877/cma.j.issn.2095-2015.2023.06.025

Abstract

Abstract:

Objective

To investigate the effect of oral metformin on postoperative recurrence of type 2 diabetes mellitus with colorectal adenoma.

Methods

Prospectively, 186 patients with type 2 diabetes mellitus with colorectal adenoma who underwent endoscopic mucosal resection(EMR)in Fengfeng General Hospital of North China Medical and Healthcare Group were included from June 2019 to June 2022, and finally 150 patients were enrolled and divided into the control group and the observation group by randomized alphabetical method, with 75 patients in each group.The patients in the control group were given conventional treatments such as nutritional support and insulin to control blood glucose after surgery; the patients in the observation group were treated with oral metformin on the basis of the control group.The clinical efficacy, serum inflammation index, recurrence and adverse reactions were compared between the two groups.

Results

The treatment apparent rate 5 months after operation and total effective rate of the observation group were significantly higher than those of the control group(73.33% vs.36.00%、89.33% vs.60.00%, P<0.05). The levels of serum inflammation indexes of patients in the two groups were significantly lower compared with the preoperative period, and the C-reactive protein, interleukin-6 and interleukin-8 of the observation group were significantly lower than those of the control group [(4.21±0.23)mg/L vs.(5.13±0.11)mg/L, (4.92±2.57)pg/mL vs.(6.13±3.11)pg/mL, (42.14±2.52)pg/mL vs.(45.21±2.48)pg/mL, P<0.05]. In addition, the relapse rate in the observation group was significantly lower than that in the control group(21.00% vs.42.67%, P<0.05). Meanwhile, there was no statistically significant difference in the total incidence of adverse reactions during treatment between the two groups.

Conclusion

Metformin can significantly inhibit postoperative recurrence of colorectal adenoma in patients with type 2 diabetes mellitus, and can further relieve inflammation with high safety.

Key words: Type 2 diabetes mellitus, Colorectal adenoma, Endoscopic mucosal resection, Metformin, Recurrence rate, Adverse effects

Zhengying Zhang, Yang Ju, Xiaoning Liu. Effect of oral metformin on postoperative recurrence of type 2 diabetes mellitus with colorectal adenoma[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 485-488.

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Figures/Tables 5

References 22

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组别	例数	性别[例(%)]		年龄(岁，±s)	体重指数(kg/m²，±s)	病程(年，±s)	空腹血糖(mmol/L，±s)	腺瘤数[例(%)]
组别	例数	男	女	年龄(岁，±s)	体重指数(kg/m²，±s)	病程(年，±s)	空腹血糖(mmol/L，±s)	>2个	≤2个
对照组	75	42(56.00)	33(44.00)	45.37±2.34	22.34±0.22	1.02±0.21	9.71±0.22	40(53.33)	35(46.67)
观察组	75	39(52.00)	36(48.00)	46.01±0.24	22.35±2.04	1.04±0.13	9.49±0.24	32(42.67)	43(57.33)
t/χ²		0.242		1.291	1.374	1.523	1.367	1.709
P		0.623		0.447	0.522	0.691	0.824	0.191
组别	例数	腺瘤直径[例(%)]		腺瘤位置[例(%)]			病理类型[例(%)]
组别	例数	≥1 cm	<1 cm	左半结肠	右半结肠	全结肠	管状腺瘤	绒毛状腺瘤	混合性腺瘤
对照组	75	28(37.33)	47(62.67)	23(30.67)	19(25.33)	33(44.00)	20(26.67)	22(29.33)	33(44.00)
观察组	75	34(45.33)	41(54.67)	15(20.00)	28(27.33)	32(42.67)	30(40.00)	17(22.67)	28(37.33)
t/χ²		0.992		3.423			3.051
P		0.319		0.181			0.217

组别	例数	性别[例(%)]		年龄(岁，±s)	体重指数(kg/m²，±s)	病程(年，±s)	空腹血糖(mmol/L，±s)	腺瘤数[例(%)]
组别	例数	男	女	年龄(岁，±s)	体重指数(kg/m²，±s)	病程(年，±s)	空腹血糖(mmol/L，±s)	>2个	≤2个
对照组	75	42(56.00)	33(44.00)	45.37±2.34	22.34±0.22	1.02±0.21	9.71±0.22	40(53.33)	35(46.67)
观察组	75	39(52.00)	36(48.00)	46.01±0.24	22.35±2.04	1.04±0.13	9.49±0.24	32(42.67)	43(57.33)
t/χ²		0.242		1.291	1.374	1.523	1.367	1.709
P		0.623		0.447	0.522	0.691	0.824	0.191
组别	例数	腺瘤直径[例(%)]		腺瘤位置[例(%)]			病理类型[例(%)]
组别	例数	≥1 cm	<1 cm	左半结肠	右半结肠	全结肠	管状腺瘤	绒毛状腺瘤	混合性腺瘤
对照组	75	28(37.33)	47(62.67)	23(30.67)	19(25.33)	33(44.00)	20(26.67)	22(29.33)	33(44.00)
观察组	75	34(45.33)	41(54.67)	15(20.00)	28(27.33)	32(42.67)	30(40.00)	17(22.67)	28(37.33)
t/χ²		0.992		3.423			3.051
P		0.319		0.181			0.217

组别	例数	显效	有效	无效	总有效率
对照组	75	27(36.00)	18(24.00)	30(40.00)	45(60.00)
观察组	75	55(73.33)	12(16.00)	8(10.67)	67(89.33)
χ²		9.561	1.202	12.737	4.321
P		0.002	0.273	0.000	0.037

组别	例数	显效	有效	无效	总有效率
对照组	75	27(36.00)	18(24.00)	30(40.00)	45(60.00)
观察组	75	55(73.33)	12(16.00)	8(10.67)	67(89.33)
χ²		9.561	1.202	12.737	4.321
P		0.002	0.273	0.000	0.037

组别	例数	CRP(mg/L)				IL-6(pg/mL)				IL-8(pg/mL)
组别	例数	术前	术后	t	P	术前	术后	t	P	术前	术后	t	P
对照组	75	8.27±0.13	6.33±0.37	4.472	0.035	8.22±4.56	6.53±3.57	3.891	0.034	52.37±4.27	43.36±2.26	7.264	0.025
观察组	75	8.22±0.16	5.02±0.26	5.263	0.028	8.04±4.21	4.27± 2.26	5.995	0.021	53.23±4.16	40.17±2.31	8.347	0.012
t		0.882	0.426			0.829	0.318			0.747	0.228
P		1.294	0.037			1.183	0.029			1.372	0.023

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