Stagi Stefano, Lapi Elisabetta, Seminara Salvatore, Pelosi Paola, Del Greco Paolo, Capirchio Laura, Strano Massimo, Giglio Sabrina, Chiarelli Francesco, de Martino Maurizio
Ital J Pediatr. 2015 Feb 15;41:10. doi: 10.1186/s13052-015-0109-7.
Treatments for childhood obesity are critically needed because of the risk of developing co-morbidities, although the interventions are frequently time-consuming, frustrating, difficult, and expensive.
We conducted a longitudinal, randomised, clinical study, based on a per protocol analysis, on 133 obese children and adolescents (n = 69 males and 64 females; median age, 11.3 years) with family history of obesity and type 2 diabetes mellitus (T2DM). The patients were divided into three arms: Arm A (n = 53 patients), Arm B (n = 45 patients), and Arm C (n = 35 patients) patients were treated with a low-glycaemic-index (LGI) diet and Policaptil Gel Retard, only a LGI diet, or only an energy-restricted diet (ERD), respectively. The homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda, insulinogenic and disposition indexes were calculated at T0 and after 1 year (T1).
At T1, the BMI-SD scores were significantly reduced from 2.32 to 1.80 (p < 0.0001) in Arm A and from 2.23 to 1.99 (p < 0.05) in Arm B. Acanthosis nigricans was significantly reduced in Arm A (13.2% to 5.6%; p < 0.05), and glycosylated-haemoglobin levels were significantly reduced in Arms A (p < 0.005). The percentage of glucose-metabolism abnormalities was reduced, although not significantly. However, the HOMA-IR index was significantly reduced in Arms A (p < 0.0001) and B (p < 0.05), with Arm A showing a significant reduction in the insulinogenic index (p < 0.05). Finally, the disposition index was significantly improved in Arms A (p < 0.0001) and B (p < 0.05).
A LGI diet, particularly associated with the use of Policaptil Gel Retard, may reduce weight gain and ameliorate the metabolic syndrome and insulin-resistance parameters in obese children and adolescents with family history of obesity and T2DM.
由于儿童肥胖有引发合并症的风险,因此急需针对儿童肥胖的治疗方法,尽管这些干预措施通常耗时、令人沮丧、困难且昂贵。
我们基于符合方案分析,对133名有肥胖和2型糖尿病(T2DM)家族史的肥胖儿童及青少年(n = 69名男性和64名女性;中位年龄11.3岁)进行了一项纵向随机临床研究。患者被分为三组:A组(n = 53例患者)、B组(n = 45例患者)和C组(n = 35例患者),分别接受低血糖指数(LGI)饮食加缓释保心丸、仅LGI饮食或仅能量限制饮食(ERD)治疗。在T0和1年后(T1)计算胰岛素抵抗的稳态模型评估(HOMA-IR)以及松田指数、胰岛素生成指数和处置指数。
在T1时,A组的BMI-SD评分从2.32显著降至1.80(p < 0.0001),B组从2.23降至1.99(p < 0.05)。A组的黑棘皮病显著减轻(从13.2%降至5.6%;p < 0.05),A组糖化血红蛋白水平显著降低(p < 0.005)。葡萄糖代谢异常的百分比有所降低,尽管不显著。然而,A组(p < 0.0001)和B组(p < 0.05)的HOMA-IR指数显著降低,A组的胰岛素生成指数显著降低(p < 0.05)。最后,A组(p < 0.0001)和B组(p < 0.05)的处置指数显著改善。
LGI饮食,特别是与使用缓释保心丸联合使用时,可能会减少肥胖儿童及青少年(有肥胖和T2DM家族史)的体重增加,并改善代谢综合征和胰岛素抵抗参数。