Addition of metformin to a lifestyle modification program in adolescents with insulin resistance
Addition of metformin to a lifestyle modification program in adolescents with insulin resistance
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DOI：
10.1016/j.jpeds.2008.01.018
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发表时间：
2008-06-01
影响因子：
5.1
通讯作者：
Zeitler, Phil
中科院分区：
文献类型：
--
作者：
Love-Osborne, Kathy;Sheeder, Jeanelle;Zeitler, Phil
目的评价二甲双胍是否能改善肥胖青少年的体重减轻和临床状况，研究设计：在一项随机双盲安慰剂对照试验中，85名胰岛素抵抗的青少年被随机分为二甲双胍组（70%）和安慰剂组（30%），沿着每月目标设定饮食和运动调整。人体测量，空腹血液分析，葡萄糖耐量试验进行了基线和6 months.Results平均年龄为15.7岁。平均体重指数（BMI）为39.7 kg/m2。71%是女性，58%是西班牙裔，34%是非洲裔美国人。76%的参与者完成了研究。单独设定目标并不能显著减轻体重。此外，二甲双胍组和安慰剂组在体重减轻或葡萄糖代谢指标方面无组间差异。然而，在服用二甲双胍的女性中，安慰剂组中未观察到BMI显著降低。此外，二甲双胍依从性，当伴随生活方式改变时，是BMI降低5%或更多的预测因子。在10名坚持二甲双胍并减少进食量的受试者中，60%的受试者BMI下降> 5%。结论在这组以少数民族为主的青少年中，单靠每月目标设定并不能导致体重减轻。尽管添加二甲双胍对总体体重减轻没有影响，但该药物确实显著增加了女性体重减轻，并且通过二甲双胍依从性程度预测体重减轻。然而，体重减轻只在那些报告生活方式改变的参与者中发现，特别是部分大小的减少。这些结果表明，二甲双胍可能是一种有用的药物，以促进女孩进行适度的生活方式改变的短期体重减轻。
Objective To evaluate whether metformin, when added to a program of personal goal setting, improves weight loss and clinical status in obese adolescents.Study design In a randomized double-blind placebo controlled trial, 85 adolescents with insulin resistance were randomized to receive metformin (70%) or placebo (30%), along with monthly goal setting for diet and exercise modification. Anthropometric measures, fasting blood analysis, and glucose tolerance tests were performed at baseline and 6 months.Results Mean age was 15.7 years. Mean body mass index (BMI) was 39.7 kg/m(2). 71% were female, 58% were Hispanic, and 34% were African-American. 76% of participants completed the study. Goal setting alone did not result in significant weight loss. In addition, there were no group differences between metformin and placebo in weight loss or measures of glucose metabolism. However, among females taking metformin, there was a significant decrease in BMI not seen in the placebo group. Furthermore, metformin adherence, when accompanied by lifestyle change, was a predictor of BMI decrease of 5% or more. 60% of 10 subjects who adhered to metformin and decreased portion size decreased BMI by > 5%.Conclusions in this group of predominately minority adolescents, monthly goal setting alone did not lead to weight loss. Although the addition of metformin had no effect on weight loss overall, the agent did significantly increase weight loss among females and weight loss was predicted by degree of metformin adherence. However, weight loss was only found in those participants also reporting lifestyle change, particularly a decrease in portion sizes. These results suggest that metformin may be a useful agent to promote short-term weight loss among girls making modest lifestyle changes.