The effects of metformin on body mass index and glucose tolerance in obese adolescents with fasting hyperinsulinemia and a family history of type 2 diabetes
The effects of metformin on body mass index and glucose tolerance in obese adolescents with fasting hyperinsulinemia and a family history of type 2 diabetes
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DOI：
10.1542/peds.107.4.e55
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发表时间：
2001-04-01
期刊：
影响因子：
8
通讯作者：
Bursey, D
中科院分区：
文献类型：
--
作者：
Freemark, M;Bursey, D
目标.在过去的一代人中，美国青少年中2型糖尿病的患病率显著增加。虽然导致2型糖尿病发展的因素很复杂，而且尚未完全阐明，但严重肥胖、高胰岛素血症和2型糖尿病家族史的三联体使儿童患该疾病的风险增加。目前预防2型糖尿病的方法，包括饮食咨询和运动，取得的成功有限。我们推断，增加糖尿病患者葡萄糖耐量的药物可能有助于预防高危患者葡萄糖耐受不良的进展。为此，我们进行了一项双盲、安慰剂对照研究，观察二甲双胍对空腹高胰岛素血症和有2型糖尿病家族史的肥胖青少年的体重指数（BMI）、血清瘦素、糖耐量和血脂的影响。研究人群包括29名12至19岁的白色和黑人青少年。所有患者的BMI均超过30 kg/m2。入组标准包括：1）空腹胰岛素浓度超过15 mU/mL;和2）至少1个一级或二级亲属患有2型糖尿病。所有患者的空腹血糖浓度
Objectives. The prevalence of type 2 diabetes in American adolescents has increased markedly during the past generation. Although the factors that contribute to the development of type 2 diabetes are complex and not wholly elucidated, the triad of severe obesity, hyperinsulinemia, and a family history of type 2 diabetes places a child at an increased risk for development of the disease. Current approaches to the prevention of type 2 diabetes, including dietary counseling and exercise, have had limited success. We reasoned that drugs that increase glucose tolerance in diabetic patients might prove useful in preventing the progression to glucose intolerance in high-risk patients. To that end, we conducted a double-blind, placebo-controlled study of the effects of metformin on body mass index (BMI), serum leptin, glucose tolerance, and serum lipids in obese adolescents with fasting hyperinsulinemia and a family history of type 2 diabetes.Methods. The study population consisted of 29 white and black adolescents aged 12 to 19 years. All had BMIs exceeding 30 kg/m(2). Criteria for enrollment included: 1) a fasting insulin concentration exceeding 15 mU/mL; and 2) at least 1 first-or second-degree relative with type 2 diabetes. All patients had fasting plasma glucose concentrations