二甲双胍联合胰岛素治疗小儿肥胖症合并高胰岛素血症对代谢指标的影响  

Effects of metformin combined with insulin on metabolic indexes in obese children with hyperinsulinemia

作　　者：郎琼 曹艳丽 王谦 霍美玲 徐月勤 LANG Qiong;CAO Yan-li;WANG Qian(Department of Neurology and Endocrinology,Jinan Children's Hospital,Jinan 250022,China)

机构地区：[1]济南市儿童医院神经内分泌科,250022 [2]山东第一医科大学第一附属医院儿童保健科,250014

出　　处：《中国现代药物应用》2022年第19期26-29,共4页Chinese Journal of Modern Drug Application

摘　　要：目的 研究二甲双胍联合胰岛素治疗小儿肥胖症合并高胰岛素血症对代谢指标的影响。方法 60例肥胖症合并高胰岛素血症患儿,随机分为对照组和观察组,每组30例。对照组采用皮下注射胰岛素治疗,观察组采用二甲双胍联合皮下注射胰岛素治疗。比较两组患儿治疗前后体质量指数(BMI)、腰臀比(WHR)、血糖代谢指标[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]、血脂代谢指标[高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)、总胆固醇(TC)]和药物不良反应发生率。结果 治疗后,观察组患儿BMI(18.48±2.32)kg/m2、WHR(0.78±0.08)均显著低于对照组的(20.12±2.33)kg/m2、(0.91±0.05),差异具有统计学意义(P<0.05)。治疗后,观察组患儿FPG(5.08±1.17)mmol/L、2 h PG(8.86±2.25)mmol/L、HbA1c(5.42±0.52)%均显著低于对照组的(5.74±1.12)mmol/L、(10.01±2.14)mmol/L、(6.04±0.75)%,差异具有统计学意义(P<0.05)。治疗后,观察组患儿TC(5.04±1.15)mmol/L、TG(2.12±0.65)mmol/L、LDL-C(2.38±0.79)mmol/L显著低于对照组的(5.65±1.12)、(2.62±0.85)、(2.86±0.88)mmol/L,HDL-C(1.68±0.52)mmol/L显著高于对照组的(1.29±0.43)mmol/L,差异具有统计学意义(P<0.05)。两组患儿药物不良反应发生率比较差异无统计学意义(P>0.05)。结论 二甲双胍联合胰岛素治疗小儿肥胖症合并高胰岛素血症可有效改善患儿的血糖、血脂代谢紊乱,治疗效果优于单一使用胰岛素。Objective To study the effects of metformin combined with insulin on metabolic indexes in obese children with hyperinsulinemia.Methods A total of 60 obese children with hyperinsulinemia were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with subcutaneous insulin injection,and the observation group was treated with metformin combined with subcutaneous insulin injection.Both groups were compared in terms of body mass index(BMI),waist-to-hip ratio(WHR),blood glucose metabolism indexes[fasting plasma glucose(FPG),2-h postprandial glucose(2 h PG),glycosylated hemoglobin(HbA1c)],blood lipid metabolism indexes[high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),triglycerides(TG),total cholesterol(TC)]before and after treatment,and incidence of adverse drug reactions.Results After treatment,the BMI(18.48±2.32)kg/m2 and WHR(0.78±0.08)of the observation group were significantly lower than(20.12±2.33)kg/m2 and(0.91±0.05)of the control group,and the differences were statistically significant(P<0.05).After treatment,the FPG(5.08±1.17)mmol/L,2 h PG(8.86±2.25)mmol/L and HbA1c(5.42±0.52)%in the observation group were significantly lower than(5.74±1.12)mmol/L,(10.01±2.14)mmol/L,and(6.04±0.75)%in the control group,and the differences were all statistically significant(P<0.05).After treatment,the TC(5.04±1.15)mmol/L,TG(2.12±0.65)mmol/L,LDL-C(2.38±0.79)mmol/L in the observation group were significantly lower than(5.65±1.12),(2.62±0.85),(2.86±0.88)mmol/L in the control group;the HDL-C(1.68±0.52)mmol/L in the observation group was significantly higher than(1.29±0.43)mmol/L in the control group;the differences were all statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion Metformin combined with insulin in the treatment of obese children with hyperinsulinemia can effectively improve blood glucose,blood

关 键 词：二甲双胍 胰岛素 小儿肥胖症 高胰岛素血症 代谢指标 

分 类 号：R725.8[医药卫生—儿科]