Metformin as treatment for overweight and obese adults: A systematic review
Metformin as treatment for overweight and obese adults: A systematic review
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DOI：
10.1370/afm.343
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发表时间：
2005-09-01
影响因子：
4.4
通讯作者：
Wilson, SA
中科院分区：
文献类型：
--
作者：
Levri, KM;Slaymaker, E;Wilson, SA
目的：我们想要确定二甲双胍对于治疗无糖尿病或多囊卵巢综合征（PCOS）的超重或肥胖成年人是否是一种有效的药物。
方法：我们检索了MEDLINE（1966 - 2003年）、EMBASE（1986 - 2003年）、联合与补充医学数据库（1985 - 2003年）、国际药学文摘（1970 - 2003年）、考克兰图书馆、美国医师学会杂志俱乐部、效果综述文摘数据库、考克兰对照试验注册库、MEDLINE正在处理及其他未索引的引文、检索到的文章的参考文献列表以及选定作者和制药厂商的文章。纳入标准为体重指数（BMI）达到25 kg/m²或更高，或腰臀比（WHR）大于0.8判定为肥胖或超重，使用二甲双胍，年龄18岁或以上。排除标准为诊断患有糖尿病、多囊卵巢综合征或具有多囊卵巢综合征的相关描述、人类免疫缺陷病毒感染以及同时使用抗精神病药物。试验按照11分的贾达德量表进行评分。仅接受随机对照和盲法试验。两名评审员独立从每项试验中提取数据。主要测量结果是BMI、WHR和体重的变化。
结果：最初确定了57项可能相关的研究；其中48项因缺乏随机化、缺乏盲法、不符合纳入或排除标准、结果无法获取或研究设计不当而被排除。9项临床试验符合有效性评估标准，4项研究使用了腰臀比这一参数，3项研究包括BMI，8项使用了体重。9项研究中有2项显示腰臀比有小幅降低。
结论：对于使用二甲双胍治疗无糖尿病或多囊卵巢综合征的超重或肥胖成年人，证据不足。需要进一步的研究来回答这一临床问题。
PURPOSE We wanted to determine whether metformin is an effective medication for treatment of overweight or obese adults who do not have diabetes mellitus or polycystic ovary syndrome (PCOS).METHODS We searched MEDLINE (1966-2003), EMBASE (1986-2003), Allied and Complementary Medicine Database (1985-2003), International Pharmaceutical Abstracts (1970-2003), the Cochrane Library, American College of Physicians journal Club, Database of Abstracts of Reviews of Effects, Cochrane Controlled Trials Register, MEDLINE In-Process & Other Non-indexed Citations, reference lists of retrieved articles, and articles by selected authors and pharmaceutical manufacturers. Inclusion criteria were being obese or overweight determined by a BMI of 25 kg/m(2) or greater or waist-to-hip ratio (WHR) of more than 0.8, metformin use, and aged 18 years or older. Exclusion criteria were a diagnosis of diabetes mellitus, polycystic ovarian syndrome or descriptors of polycystic ovarian syndrome, human immunodeficiency virus infection, and concomitant ;antipsychotic medications. Trials were graded on an 11-point Jadad scale. Only randomized controlled and blinded trials were accepted. Two reviewers independently extracted data from each trial. Primary outcomes measured were changes in BMI, WHR, and weight.RESULTS Fifty-seven potentially relevant studies were initially identified; 48 were excluded because of lack of randomization, lack of blinding, failure to meet inclusion or exclusion criteria, inaccessible outcomes, or improper study design. Nine clinical trials met criteria for validity assessment, Four studies used the parameter of waist-to-hip ratio, 3 studies included BMI, and 8 used weight. Two of the 9 studies showed a small reduction in WHR.CONCLUSION Insufficient evidence exists for the use of metformin as treatment of overweight or obese adults who do not have diabetes mellitus or polycystic ovary syndrome. Further studies are needed to answer this clinical question.