大剂量二甲双胍治疗肥胖患者的疗效研究

目的 观察二甲双胍对肥胖患者体成分、代谢综合征(MS)指标的影响。方法 将5 4例肥胖患者随机分成两组,A组行饮食控制兼有氧运动,B组在上述基础上联用二甲双胍0 .85 g,每日2次。分别于0、4、8、12周测量全身脂肪重量(Fat mass)、脂肪百分数(Fat% )、基础代谢率、去脂体重(FFM)、血压(BP)、腰围(WC) ;0、12周测血清总胆固醇(TC)、高密度脂蛋白胆固醇(HDL- C)、低密度脂蛋白胆固醇(L DH- C)、甘油三酯(TG)、空腹血糖(FPG)及空腹胰岛素(FL NS)。结果 5 4例中4 6例完成研究。B组体重下降8.5 % (P<0 .0 0 1)、Fat mass减轻11.8% (P<0 .0 0 1)、FFM下降4 .5 % (P<0 .0 1) ,体重指数(BMI)下降7.1% (P<0 .0 1) ,收缩压(SBP)下降8.3%(P<0 .0 1)、舒张压(DBP)下降10 .2 % (P<0 .0 1)、WC缩小4 .5 % (P<0 .0 1)、TG下降30 .1% (P<0 .0 1)、FL NS水平下降5 1.3% (P<0 .0 1)。B组第4周时体重下降幅度最大,12周结束时稍增加(P=0 .6 4 9)。两组比较BW、BMI、FFM、腰围下降均有差异(P<0 .0 5 ) ;两组TC降低及HDL- C升高也有差异(P<0 .0 5 )。 结论 1大剂量二甲双胍联合饮食控制和运动,能更好地减轻体重;2两组在第4周时体重均明显下降,12周后B组比A组疗效好,提示两种疗法开始均有效,但B组长期疗效更好;3二甲双胍可改?

Objective To explore the ef fects of metfo rmin on body composition and metabolic syndrome components.Methods In a 12-week prospective study,54 obese patients were randomized into two groups:group A experienced diet control,impro ving physical activity and lifestyle modification,group B add metformin 850mg o n the basis of above.Body composition was measured with TANATA during0 ,4,8 and 12 week,waist circumference,blood pressure ,lipid profiles,fastin g serum glucose and insulin were measured during 0 and 12 week.Resul ts 46 of 54 p atients finished study.Body weight ,fat mass,FFM,BMI,SBP,DBP,WC,TG decre ased 8.5%,11.8%,4.5%,7.1%,8.3%,10.2%,4.5%,30.1% respectively comp ared with baseline in group B.The differences of changes in body weight,BMI,F FM,WC,TG and HDL-C between two groups were statistically significant. Conlusio n Added metformin to diet control,physical activity and lifestyle modification has a better effect on weight loss,metformin can improve the com ponents of metabolic syndrome.