Effects Of Metformin On Obesity-related Insulin Resistance In Children

Background With the rapid development of economic globalization,the chlidren obesity problem has abviously increased in recent years.Children obesity has become a serious worldwide health problem.It is urgent to take effective measures to control obesity.The current treatments of obesity mainly include: diet controlphysical exercise,drug therapy,cognitive therapy and surgery.And among all these therapies,the drug therapy seems to be the most important part.Metformin can not only be used to treat children with diabetes,but also playing a important role in controlling body weight.Purposes Our study will explore whether metformin can reduce the weight and body mass index(BMI)of obese children,and improve insulin resistance and lipid metabolism disorders.In addition,the efficacy of metformin alone in the treatment of type 2 diabetes(T2DM)mellitus was also observed.Materials and methods We selected 41 children(aged 9-14)who were diagnosed with obesity and insulin resistance in the Pediatrics of the Second Affiliated Hospital of Dalian Medical University from June 2010 to October 2016 as the treatment group.And all the patients were given metformin for 12 weeks.After then,the changes of height,weight,BMI,fasting blood glucose(FBG),fasting insulin,C peptide,glycosylated hemoglobin(HAb1C),HOMA-IR,triglyceride,low density lipoprotein,high density lipoprotein and serum cholesterol were observed.Besides,20 cases of normal weight and height children(aged9-14)were selected as control group.They also in the Second Affiliated Hospital of Dalian Medical University pediatric clinic for routine physical examination in the same period.The status of HOMA-IR was compared between the treatment group and control group.In statistics,for the metrological data,the normal distribution is expressed as the mean ± standard deviation( (?)±S).The two sets of data were compared using t test,and the data that does not satisfy the normal distribution are expressed as the median(P25P75),using the nonparametric test.Count datas were compared using chi-square test.Calculating P value,P<0.05 suggested that the difference was statistically significant.And 1 case of child aged 10.58 in the the Second Affiliated Hospital of Dalian Medical University pediatric hospitalized in March 2016,diagnosed as type 2 diabetes and obesity,monitoring their fasting blood glucose,glycosylated hemoglobin and HOMA-IR eight months with metformin alone.Results1.There was no significant difference in mean age,gender and fasting blood glucose between obese children and normal weight group(P>0.05).The levels of BMI,fasting insulin and Ln(HOMA-IR)in the treatment group were significantly higher than those in the normal body weight group,the differences were statistically significant(P<0.001).2.Children in the treatment group who take metformin for 12 weeks,the weight reduced from(74.66 ± 15.02)kg to(71.91 ± 14.19)kg(P=0.004),the level of BMI were significantly reduced from(29.36 ± 4.42)kg/m~2 to(27.40 ± 3.99)kg/m~2,the difference was statistically significant(P<0.001),the height increased(P=0.002).3.Children in the treatment group received oral metformin treatment after 12 weeks,the fasting blood glucose decreased,the difference was statistically significant(P=0.002),the Ln(HOMA-IR),fasting insulin,C peptide,glycosylated hemoglobin decreased obviously,the differences was statistically significant(P<0.001).4.Children in the treatment group,the HOMA-IR of 27 cases(65.85%)decreased to less than 3.5 after the treatment of metformin for 12 weeks,and 24 cases(58.54%)had lower HOMA-IR below 3.16.5.Children in the treatment group received oral metformin treatment after 12 weeks,triglyceride decreased,the difference was statistically significant(P=0.002),low density lipoprotein and total cholesterol decreased significantly,the differences was statistically significant(P<0.001),while no significant change of high density lipoprotein(P=0.635).6.In addition,an obese girl who was diagnosed as type 2 diabetes mellitus was treated with oral Metformin.And the fasting blood glucose decreased to normal after 3 days,the glycosylated hemoglobin decreased to normal after 2 months,and HOMA-IR showed a decreasing trend with metformin alone.7.There were 4 cases(9.52%)of adverse reactions in the treatment of metformin,all of which were gastrointestinal reactions,1 case of diarrhea,3 cases of nausea and mild abdominal pain,all occurred within 2 weeks of treatment.And all the side effects faded over some time without any treatment.Conclusions1.Metformin is able to reduce the weight and BMI of obese children.2.Metformin is able to regulate glucose metabolism disorders and improve insulin resistance in obese children.3.Metformin is able to reduce the triglycerides,low-density lipoprotein and totalcholesterol in obese children.4.Metformin is able to treat adolescents with T2 DM.