Role of metformin for weight management in patients without type 2 diabetes
Role of metformin for weight management in patients without type 2 diabetes
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DOI：
10.1345/aph.1k656
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发表时间：
2008-06-01
影响因子：
2.9
通讯作者：
Dunican, Kaelen C.
中科院分区：
文献类型：
--
作者：
Desilets, Alicia R.;Dhakal-Karki, Sushmita;Dunican, Kaelen C.
目的：评价二甲双胍对非2型糖尿病超重和肥胖患者体重控制的有效性和安全性。资料来源：检索MEDLINE OVID(1950-2008年2月3周)、EMBASE(所有年份)，并对相关文献进行文献综述。关键词包括MetFromin、肥胖、超重和体重减轻。研究选择/数据提炼：对所有评价二甲双胍对肥胖或超重个体体重影响的英文研究进行批判性分析。数据综合：二甲双胍是治疗超重或肥胖的2型糖尿病患者的一线药物疗法，对这一人群的体重有好处。多项试验评估了二甲双胍对非糖尿病成人和青少年的体重和其他代谢参数的影响。在12项成人试验中，有5项将体重减轻作为主要终点。在这些研究中，有4项发现体重显著减轻；然而，这些试验规模小，设计薄弱。体重减轻在6个青少年试验中有5个显著；同样，这些研究受到研究设计薄弱和患者人数较少的限制。代谢参数(血压、腰围、胆固醇参数、胰岛素/血糖水平)经常显示不同的结果。二甲双胍耐受性良好；胃肠道反应是最常见的不良反应。结论二甲双胍在无糖尿病的超重或肥胖的成年人和青少年中的减肥效果是有希望的；然而，试验受到患者人数少和设计薄弱的限制。二甲双胍还可能对腰围、空腹胰岛素和血糖水平以及甘油三酯等代谢参数有积极影响。进一步的研究包括评估体重减轻作为主要结果的大规模试验，对于确定二甲双胍在该人群中的作用是必要的。
OBJECTIVE: To evaluate the efficacy and safety of metformin for weight management in overweight and obese patients without type 2 diabetes.DATA SOURCES: Literature was obtained through MEDLINE Ovid(1950- February week 3, 2008), EMBASE (all years), and a bibilographic review of relevant articles. Key words included metfromin, obesity, overweight and weight loss.STUDY SELECTION/DATA EXTRACTION: All studies published in the English language that evaluated the effects of metformin on weight in obese or overweight individuals were critically analyzed. Relevant articles were selected for inclusion in this review.DATA SYNTHESIS: Metformin is first-line pharmacotherapy in the treatment of overweight or obese patients with type 2 diabetes, with beneficial effects on weight in this population. Multiple trails have evaluated the effect of metformin on weight and other metabolic paramenters in adults and adolescents without diabetes. Five of 12 trials in adults evaluated weight loss as a primary endpoint. Significant weight reduction was found in 4 of these studies; however, the trials were small and of weak design. Weight reduction was significant in 5 of the 6 adolescent trails; similarly, these studies were limited by weak study design and small patient population. Metabolic parameters (blood pressure, waist circumference, cholestreol parameters, insulin/glucose levels) often showed varying results. Metformin was well tolerated; gastrointestinal effects were the most frequently reported adverse effects.CONCLUSION The weight loss effects of metformin in overweight or obese adults and adolescents without diabetes appear promising; however, trials have been limited by small patient populations and weak design. Metformin may also have a positive effect on metabolic parameters such as waist circumference, fasting insulin and glucose levels, and triglycerides. Further research involving largescale trails that evaluate weight loss as a primary outcome is necessary to firmly establish the role of metformin in this population.