二甲双胍对糖尿病患者黄斑区视网膜厚度的影响

Effect of Metformin on Retinal Thickness in the Macular Area of Diabetic Patients

摘要: 目的：研究二甲双胍对糖尿病患者黄斑区视网膜厚度的影响。方法：回顾性队列研究。选择2024年10月至2024年12月于青岛大学附属医院内分泌科和眼科就诊的无视网膜病变的2型糖尿病患者32人(63眼)，根据所使用降糖方案是否含有二甲双胍分为两组：二甲双胍组15人(30眼)及非二甲双胍组17人(33眼)。使用TowardPi YG-100K PRO OCT仪测量两组患者黄斑中心凹(距中心小凹直径1000 μm)及黄斑上方、下方、鼻侧、颞侧(距离中心小凹直径3000 μm)区域的视网膜厚度及神经节细胞复合体(GCC)厚度。统计学分析两组患者黄斑区视网膜厚度及GCC厚度是否存在统计学差异。结果：两组基线资料(性别、年龄、糖尿病病程)无统计学差异(P > 0.05)。二甲双胍组患者黄斑中心凹、上方、下方、鼻侧及颞侧视网膜厚度平均值高于非二甲双胍组，两组之间差异均有统计学意义(t_中 = 4.57, P < 0.01; U_上 = 210.50, P < 0.01; t_下 = 3.42, P < 0.01; t_鼻 = 5.57, P < 0.01; t_颞 = 5.79, P < 0.01)。二甲双胍组较非二甲双胍组二甲双胍组患者患者黄斑中心凹、上方、下方及鼻侧视网膜GCC厚度平均值高于非二甲双胍组，两组之间差异均有统计学意义(U_中 = 122.50, P = 0.035; t_上 = 2.09, P = 0.045; t_下 = 2.04, P = 0.049; U_鼻 = 344, P = 0.044)。二甲双胍组患者颞侧视网膜GCC厚度平均值高于非二甲双胍组，差异无统计学意义(t_颞 = 1.81, P = 0.078)。结论：二甲双胍可能对糖尿病患者黄斑区视网膜厚度的减少具有抑制作用。

Abstract: Objective: To investigate the effects of metformin on macular retinal thickness in patients with diabetes mellitus. Methods: A retrospective cohort study included 32 type 2 diabetes patients (63 eyes) without retinopathy from Qingdao University Affiliated Hospital (October-December 2024), divided into metformin (15 patients, 30 eyes) and non-metformin groups (17 patients, 33 eyes); macular retinal thickness and ganglion cell complex (GCC) thickness were measured at central fovea (1000 μm from the central recess) and superior/inferior/nasal/temporal perifoveal regions (3000 μm from the central recess) using TowardPi YG-100K PRO OCT. Statistical analysis of whether the retinal thickness and GCC thickness in the macular area were different between the two groups. Results: There was no statistical difference in baseline data (gender, age, diabetes duration) between the two groups (P > 0.05). The metformin group exhibited higher mean retinal thickness in the central fovea, superior, inferior, nasal, and temporal regions compared to the non-metformin group, with statistically significant differences observed between the two groups (central fovea: t = 4.57, P < 0.01; superior: U = 210.50, P < 0.01; inferior: t = 3.42, P < 0.01; nasal: t = 5.57, P < 0.01; temporal: t = 5.79, P < 0.01). The metformin group also demonstrated higher mean GCC thickness in the central fovea, superior, inferior, and nasal regions compared to the non-metformin group, with statistically significant differences (central fovea: U = 122.50, P = 0.035; superior: t = 2.09, P = 0.045; inferior: t = 2.04, P = 0.049; nasal: U = 344, P = 0.044). However, although the mean temporal GCC thickness in the metformin group was higher than in the non-metformin group, the difference was not statistically significant (t = 1.81, P = 0.078). Conclusion: Metformin may have an inhibitory effect on the reduction of retinal thickness in the macular area in diabetic patients.