Effects of metformin in children and adolescents with Prader-Willi syndrome and early-onset morbid obesity: a pilot study.
Effects of metformin in children and adolescents with Prader-Willi syndrome and early-onset morbid obesity: a pilot study.
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DOI：
10.1515/jpem-2013-0116
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发表时间：
2014-01
期刊：
影响因子：
--
通讯作者：
Dykens EM
中科院分区：
文献类型：
--
作者：
Miller JL;Linville TD;Dykens EM
普瑞德威利综合征 (PWS) 是早发性儿童肥胖最常见的原因之一。患有 PWS 的人有明显的食欲过盛和饱腹感降低。进食过多的确切病因仍然未知，因此无法治疗。我们对 21 名 PWS 儿童和 6 名早期病态肥胖 (EMO) 儿童对二甲双胍的反应进行了一项试点、开放性研究。参与者在口服葡萄糖耐量测试（OGTT）中出现显着的胰岛素抵抗和葡萄糖不耐症，并开始服用二甲双胍来治疗这些生化结果。我们在开始二甲双胍治疗之前和之后对患者的父母进行了食欲过盛调查问卷。 PWS 组和 EMO 组在食欲过盛问卷中，与食物相关的痛苦、焦虑和远离食物的能力都有显着改善。在 PWS 组中，改善主要见于女性。在 PWS 组中，对二甲双胍有反应的患者 OGTT 2 小时血糖水平较高（7.48 mmol/L vs. 4.235 mmol/L；p=0.003），空腹胰岛素水平较高（116 pmol/L vs. 53.5 pmol/L；p=0.04）。此外，5/13 的 PWS 患者和 5/6 的 EMO 患者的父母报告说，他们的孩子在服用二甲双胍时能够感到饱足（对许多人来说，这是他们第一次描述饱腹感）。二甲双胍可以改善某些 PWS 和 EMO 患者的饱腹感并减少对食物的焦虑。对二甲双胍的阳性反应可能取决于高胰岛素血症和葡萄糖耐受不良的程度。尽管如此，这项试点研究的结果还需要进一步调查。
Prader-Willi syndrome (PWS) is one of the most commonly recognized causes of early-onset childhood obesity. Individuals with PWS have significant hyperphagia and decreased recognition of satiety. The exact etiology of the hyperphagia remains unknown and, therefore, untreatable. We conducted a pilot, open-label study of response to metformin in 21 children with PWS and six with early morbid obesity (EMO). Participants had significant insulin resistance and glucose intolerance on oral glucose tolerance testing (OGTT) and were started on metformin for these biochemical findings. We administered the Hyperphagia Questionnaire to parents of patients before and after starting metformin treatment. Both the PWS and EMO groups showed significant improvements in food-related distress, anxiety, and ability to be redirected away from food on the Hyperphagia Questionnaire. In the PWS group, improvements were predominantly seen in females. Within the PWS group, responders to metformin had higher 2-h glucose levels on OGTT (7.48 mmol/L vs. 4.235 mmol/L; p=0.003) and higher fasting insulin levels (116 pmol/L vs. 53.5 pmol/L; p=0.04). Additionally, parents of 5/13 individuals with PWS and 5/6 with EMO reported that their child was able to feel full while on metformin (for many this was the first time they had ever described a feeling of fullness). Metformin may improve sense of satiety and decrease anxiety about food in some individuals with PWS and EMO. Positive response to metformin may depend on the degree of hyperinsulinism and glucose intolerance. Nonetheless, the results of this pilot study bear further investigation.
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DOI：
10.1161/atvbaha.108.169722
发表时间：
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期刊：
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