Warnakulasuriya Loretta S, Fernando Manel M A, Adikaram Adikaram V N, Thawfeek Abdul R M, Anurasiri Weda-Muhandiramge L, Silva Renuka R, Sirasa Mohamed S F, Rytter Elisabet, Forslund Anders H, Samaranayake Dulani L, Wickramasinghe V Pujitha
1 Postgraduate Institute of Medicine, University of Colombo , Colombo, Sri Lanka .
2 Colombo North Teaching Hospital , Ragama, Sri Lanka .
Child Obes. 2018 Nov/Dec;14(8):553-565. doi: 10.1089/chi.2018.0043. Epub 2018 Aug 2.
Childhood obesity-related metabolic derangements are increasing among South Asian populations. Dietary and physical activity plans have limited effect. This study aims to assess the effectiveness of metformin in the management of obesity among 8- to 16-year-old children in Gampaha District of Sri Lanka.
A triple-blinded controlled trial was conducted on 150 obese school children. After 12-hour overnight fast, blood was drawn for fasting blood glucose (FBG) and lipid profile. Anthropometry, fat mass (FM), and blood pressure were measured. BMI and insulin resistance were calculated. Children randomly received either metformin (8-10 years-500 mg 12 hourly; 11-16 years-1 g 12 hourly) or placebo. Anthropometry and blood investigations were repeated at 6 and 12 months. Mean difference in outcome measures, adjusted for baseline values, was compared using ANCOVA.
There were 84/150 boys. Metabolic syndrome was present in 25 (16.7%). A statistically significant adjusted mean reduction was observed in the metformin group compared with placebo, in weight (-0.991 vs. 1.394, p = 0.000), BMI/Age-standard deviation score (SDS; -0.287 vs. -0.116, p = 0.000), %FM/Age-SDS (-0.092 vs. 0.016, p = 0.04), systolic blood pressure (SBP; -0.415 vs. 0.015, p = 0.015), total cholesterol (-0.95 vs. -0.7, p = 0.001), low-density lipoprotein (-0.67 vs. -0.45, p = 0.001), and highly sensitive C-reactive protein (-1.36 vs. 0.08, p = 0.013) at 6 months, and in BMI/Age-SDS (-370 vs. -0.222, p = 0.001), WC/Age-SDS (-0.473 vs. -0.337, p = 0.018), SBP (-0.834 vs. -0.477, p = 0.023), and triglycerides (-0.33 vs. -0.14, p = 0.019) at 12 months.
Metformin compared with placebo has beneficial effects on anthropometric and metabolic indicators in the management of childhood obesity.
南亚人群中与儿童肥胖相关的代谢紊乱情况正在增加。饮食和体育活动计划效果有限。本研究旨在评估二甲双胍对斯里兰卡甘巴哈地区8至16岁儿童肥胖管理的有效性。
对150名肥胖学童进行了一项三盲对照试验。经过12小时空腹后，采集血液用于检测空腹血糖（FBG）和血脂谱。测量人体测量学指标、脂肪量（FM）和血压。计算体重指数（BMI）和胰岛素抵抗。儿童随机接受二甲双胍（8 - 10岁 - 每12小时500毫克；11 - 16岁 - 每12小时1克）或安慰剂。在6个月和12个月时重复进行人体测量学和血液检查。使用协方差分析（ANCOVA）比较经基线值调整后的结局指标平均差异。
150名中有84名男孩。25名（16.7%）存在代谢综合征。与安慰剂组相比，二甲双胍组在6个月时观察到体重（-0.991对1.394，p = 0.000）、BMI/年龄标准差评分（SDS；-0.287对-0.116，p = 0.000）、%FM/年龄 - SDS（-0.092对0.016，p = 0.04）、收缩压（SBP；-0.415对0.015，p = 0.015）、总胆固醇（-0.95对-0.7，p = 0.001）、低密度脂蛋白（-0.67对-0.45，p = 0.001）和高敏C反应蛋白（-1.36对0.08，p = 0.013）有统计学显著的调整后平均降低，在12个月时BMI/年龄 - SDS（-0.370对-0.222，p = 0.001）、腰围/年龄 - SDS（-0.473对-0.337，p = 0.018）、SBP（-0.834对-0.477，p = 0.023）和甘油三酯（-0.33对-0.14，p = 0.019）也有降低。
与安慰剂相比，二甲双胍在儿童肥胖管理中对人体测量学和代谢指标有有益影响。
