Metformin, the oral hypoglycemic drug widely used worldwide, has become the backbone of diabetes treatment since it was first used to treat diabetes more than six decades ago. In more than 30 years of clinical use in mainland China, metformin has not only shown excellent results in the treatment of diabetes, but in recent years, research has found that it may also have a range of exciting new uses.
Anti-aging
At present, the U.S. Food and Drug Administration (FDA) has approved clinical trials for "anti-aging with metformin", and the reason why scientists use metformin as an anti-aging drug candidate may be because metformin can increase the number of oxygen molecules released into cells, which seems to increase the body's strength and longevity.
Protects the cardiovascular system
The role of metformin in cardiovascular protection has received a lot of research attention. It has shown potential protective effects in a variety of cardiovascular disease models, including myocardial ischemia-reperfusion injury, myocardial hypertrophy, heart failure, and atherosclerosis. Its anti-inflammatory and antioxidant properties may help improve endothelial function and reduce cardiomyocyte fibrosis, which can have a positive effect on cardiac remodeling.
Lose weight
Metformin is a hypoglycemic drug that can lose weight. It increases insulin sensitivity and decreases fat synthesis. For many type 2 sugar friends, weight loss itself is a thing that is conducive to stable blood sugar control. A study by the American Diabetes Prevention Program (DPP) research team showed that in the unblinded study for 7~8 years, patients treated with metformin lost an average of 3.1 kg of weight.
One animal trial also found that the regulator effect of metformin correlated with the dose of metformin.
Improvement of polycystic ovary syndrome
The main clinical manifestations of polycystic ovary syndrome (PCOS) are hyperinsulinemia, cessation of ovulation, insulin resistance, and hyperandrogenism. Studies have shown that metformin has an ameliorating effect on insulin resistance, which can effectively reduce the levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in patients and promote ovulation. However, metformin is used for the treatment of PCOS as an off-label drug. In addition, the addition of metformin for more than 6 months on the basis of lifestyle modification reduced body mass index (BMI), subcutaneous adipose tissue, and improved menstruation in patients with PCOS. Lifestyle combined with metformin can help to further control body mass.
Reverses cognitive impairment
Researchers at the University of Texas at Dallas have built a mouse model that mimics pain-related cognitive impairment. They used this model to test the efficacy of a variety of drugs. The results of the experiment showed that treating mice with metformin at 200 mg/kg body weight for 7 days could completely reverse the cognitive impairment caused by pain. Gabapentin, which treats neuralgia and epilepsy, does not have such an effect. This means that metformin can be repurposed to treat cognitive impairment in neuralgia patients.
Anti-cancer, tumor suppressor
In recent years, a number of epidemiological data have shown that metformin also has the effect of preventing tumors and even treating tumors.
Lung cancer is a disease that seriously endangers human health, with a high incidence, high mortality rate, and extremely poor prognosis, with 86% of patients dying within 5 years after diagnosis. More and more studies suggest that metformin can prevent lung cancer and improve the prognosis of lung cancer patients.
Epidemiological investigations have found that the incidence of malignant neoplasms is reduced after metformin is taken in diabetic patients. Some cell tests and clinical trials have also suggested that the combination of metformin and targeted drugs can improve the efficacy of immunotherapy drugs to enhance the effect of chemotherapy drugs. However, there are still some limitations in the current research on the anti-tumor mechanism of metformin, and many mechanisms need to be confirmed by more in-depth preclinical studies.
Assist in quitting smoking
Researchers at the University of Pennsylvania found that long-term nicotine use leads to activation of the AMPK signaling pathway, which is inhibited when nicotine is withdrawn. Therefore, they hypothesized that withdrawal may be alleviated if the AMPK signaling pathway is activated with drugs.
Metformin is an AMPK agonist. When the researchers gave metformin to mice that developed nicotine withdrawal, they found that it alleviated the withdrawal in mice. Their research suggests that metformin can be used to assist in smoking cessation.
Anti-inflammatory effect
Previously, preclinical studies and clinical studies have shown that metformin not only improves chronic inflammation by improving metabolic parameters such as hyperglycemia, insulin resistance, and atherosclerotic dyslipidemia, but also has a direct anti-inflammatory effect. Metformin has been shown to inhibit the inflammatory response, mainly through AMP-activated protein kinase (AMPK)-dependent or independent inhibition of nuclear transcription factors.
Improves intestinal flora
Studies have shown that metformin can restore the proportion of intestinal flora and shift it in a health-friendly direction. It provides an advantageous living environment for intestinal beneficial bacteria, thereby lowering blood sugar and positively regulating the immune system.
The multifaceted nature of metformin has made it a hot spot in medical research. As research progresses, we expect this classic drug to show more therapeutic potential in areas other than diabetes and bring more health benefits to patients." For primary care practitioners, understanding these emerging research findings will help provide patients with more comprehensive treatment options.
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