Long-term follow-up of non-diabetic obese children and adolescents treated with metformin

Yıl 2019, Cilt: 10 Sayı: 1, 57 - 61, 21.03.2019

Melikşah Keskin , Zehra Aycan Uğur Ufuk Işın , Semra Çetinkaya

https://doi.org/10.18663/tjcl.498721

Öz

Aim: Childhood obesity is an important public health
problem with increasing prevalence.Type 2 diabetes mellitus(T2DM) is strongly
associated with obesity and metabolic syndrome. Adressing obesity and insulin
resistance by drug treatment represents a rational strategy for the prevention
of T2DM. The aim of our study was to evaluate the
one year metformin treatment’slong-term effectiveness in children and
adolescent.

Material
and Methods: Patients who were diagnosed with obesity (VKİ>+2
SDS)and found to have insulin resistance
(total insulin at OGTT >300 mIU/ml and homa-IR >3.4)and other obesity co-morbidities, agedbetween
10-18 years, treated with metformin in addition to lifestyle change for a year and
with regular follow-up for a minimum of 2 years after metformin treatmentin our
clinicwere included inthe study.

Results:
A total of 12 cases including 8 girls with
a mean age of 13.2±2.1 years and mean follow-up duration of 3.9±1 years were
included in the study. While the body mass index (BMI) of the cases at
presentation was 31.2±5.6 kg/m² and BMI-SDS was 2.7±0.7, the BMI-SDS
value after one year of metformin treatment was found to have regressed to 1.9±1
(p:0.04), and the BMI-SDS value two years after the interruption of metformin
treatment had increased to 2.1±1.04 but was not as high as the period before
metformin treatment (p:0.033).

Conclusion:
One-year metformin treatment improved the
BMI SDS and homa-IR values of the obese children and this improvement decreased
but continued in the second year after the discontinuation of the treatment.

Anahtar Kelimeler

Obesity, insulin resistance, childhood

Metformin ile tedavi edilen non-diyabetik obez çocuk ve adolesanların uzun sureli izlemi

Öz

Amaç: Çocukluk döneminde obezite artan sıklıkla izlenen önemli bir halk
sağlığı problemidir.  Tip 2 Diyabetes mellitus
(T2DM) obezite ve metabolik sendrom ile güçlü ilişki içindedir. Tip 2 DM ‘nin
önlenmesi için obezite ve insulin direncini hedef alan ilaç tedavileri rasyonel
bir strateji olarak görülmektedir.Çalışmamızın amacı bir yıl süre ile metformin
tedavisi alan çocuk ve adolesanlarda bu tedavinin uzun dönem etkinliğini
değerlendirmektir.

Gereç ve Yöntemler: Kliniğimizde obezite (VKI>+ 2SDS ) tanısı alan ve insulin direnci olan
(OGTT’de total insulin düzeyi >300 mIU/ml ve homa IR >3,4
) ve diğer obezite ilişkili komorbiditeleri bulunan, yaşları 10-18 arası
değişen, yaşam tarzı değişikliği ile birlikte bir yıl süre ile metformin
tedavisi alan ve ardından en az iki yıl süre ile takip edilen hastalar dahil
edildi.

Bulgular: Çalışmaya
8’ i kız , ortalama yaşı 13,2±2,1 yıl olan 
ve ortalama izlem süresi 3,9±1 yıl olan toplam 12 dahil edildi.
Başlangıçta  olguların vücut kitle
indeksi (VKİ) 31,2±5,6 kg/m²ve VKİ-SDS’i 2,7±0,7 iken bir yıllık
metformin tedavisi ile VKİ-SDS’inin 1,9±1 (p:0,04) ‘ e gerilediği, iki yıl süre
ile metformin tedavisi kesilen olguların 
VKİ-SDS’ inin 2,1±1,04 (p:0,033)’ e yükseldiği ancak metformin tedavisi
öncesi kadar yüksek olmadığı görüldü.

Sonuç: Bir yıllık metformin
tedavisinin obez çocuk ve adolesanlarda VKİ-SDS ve  Homa-IR değerlerinde düzelme sağladığı, bu
düzelmenin tedavi kesiminden sonraki ikinci yılda da azalmakla birlikte devam
ettiği saptandı. 

Anahtar Kelimeler

Obezite, insülin direnci, Çocukluk dönemi

Kaynakça

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