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儿童肥胖严重程度与大流行之间的恶性循环:二甲双胍的潜在影响。

Vicious cycle between severity of childhood obesity and pandemic: Potential impact of metformin.

作者信息

Samur Bahadir M, Samur Tugba G, Gul-Sir Ulku, Hatipoglu Nihal

机构信息

Department of Pediatrics, Erciyes University, Faculty of Medicine, Kayseri, Turkey.

Department of Pediatrics, Division of Pediatric Gastroenterology Hepatology & Nutrition, Erciyes University Faculty of Medicine, Kayseri, Turkey.

出版信息

Obes Med. 2022 Aug;33:100433. doi: 10.1016/j.obmed.2022.100433. Epub 2022 Jun 13.

Abstract

INTRODUCTION

COVID-19 is currently a global pandemic, and initial reports of identified COVID-19 lockdown and limitations can adversely affect childhood obesity and metabolic health. Studies conducted in recent years have shown that the rate of obesity in childhood increases with the changing lifestyle with the pandemic. However, there is insufficient data on how the situation changes and how metabolism is affected in those, who are already obese. The aim of this paper was to determine how the pandemic affects the current status, severity, and metabolic parameters of obese children. We also attempted to show potential effects of metformin therapy.

METHODS

The study was conducted with the participation of 101 patients with obesity (The mean age was 13.6 ± 2.2). The patients were evaluated using pre- and post-lockdown data with an interval of 6 months. The new classification system was used to determine the severity of obesity. All anthropometrics, metabolic parameters (Blood glucose, insulin, HbA1C, lipid profile), lifestyle, and comorbidities were evaluated by dividing the participants into various subgroups according to their obesity and metformin usage status.

RESULTS

Our data shows that weight, height, BMI, BMI-SD, and BMI percentiles all increased significantly, after the pandemic started. The severity of obesity increased statistically (overweight decreases and class 2 obesity increases, p = 0.001). No change was observed in metabolic parameters. Surprisingly, a significant increase was observed in insulin and HOMA-IR values in the group with-metformin.

DISCUSSION

Most studies about childhood obesity have only focused on obesity increases and pandemic relation. Our study showed that although there was no significant change in metabolic status at the end of a lockdown period, there was a serious increase in the severity of obesity. Metformin use had no effect on either obesity or metabolic parameters, and even an increase in insulin resistance indicators was observed.

摘要

引言

新型冠状病毒肺炎(COVID-19)目前是全球大流行疾病,关于COVID-19封锁措施和限制措施的初步报告可能会对儿童肥胖和代谢健康产生不利影响。近年来进行的研究表明,随着大流行期间生活方式的改变,儿童肥胖率有所上升。然而,关于情况如何变化以及已经肥胖的儿童的新陈代谢如何受到影响的数据不足。本文的目的是确定大流行如何影响肥胖儿童的当前状况、严重程度和代谢参数。我们还试图展示二甲双胍治疗的潜在效果。

方法

该研究有101名肥胖患者参与(平均年龄为13.6±2.2岁)。患者在封锁前后间隔6个月的数据进行评估。使用新的分类系统来确定肥胖的严重程度。通过根据参与者的肥胖和二甲双胍使用状况将其分为不同亚组,对所有人体测量学指标、代谢参数(血糖、胰岛素、糖化血红蛋白、血脂谱)、生活方式和合并症进行评估。

结果

我们的数据显示,大流行开始后,体重、身高、体重指数(BMI)、BMI标准差(BMI-SD)和BMI百分位数均显著增加。肥胖的严重程度在统计学上有所增加(超重减少,2级肥胖增加,p = 0.001)。代谢参数未观察到变化。令人惊讶的是,使用二甲双胍的组中胰岛素和胰岛素抵抗指数(HOMA-IR)值显著增加。

讨论

大多数关于儿童肥胖的研究仅关注肥胖增加与大流行的关系。我们的研究表明,尽管在封锁期结束时代谢状态没有显著变化,但肥胖的严重程度却有严重增加。使用二甲双胍对肥胖或代谢参数均无影响,甚至观察到胰岛素抵抗指标有所增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6e6/9190200/700567240211/gr1_lrg.jpg

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