二甲双胍联合个体化营养干预治疗青少年肥胖的效果

Effect of metformin combined with individualized nutritional intervention on weight loss in adolescent obese patients

目的探讨二甲双胍联合个体化营养干预治疗青少年肥胖的减肥效果、安全性及对患者心理健康的影响。方法选取就诊的青少年肥胖患者150例,用随机数字表法分为营养干预组和联合干预组,每组75例,营养干预组给予个体化营养干预,联合干预组患者在个体化营养干预的基础上口服盐酸二甲双胍片,所有患者均干预36周。比较2组的减肥效果、心理健康状态及不良反应发生情况等。结果干预后,2组体型均显著改善,且联合干预组的效果优于营养干预组(P<0.05);2组体质量、体质量指数(body mass index,BMI)、体脂率、血清空腹血糖(fasting blood glucose,FPG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、三酰甘油(triacylglycerol,TG)水平以及焦虑自评量表(self-ratinganxietyscale,SAS)、抑郁自评量表(self depression scale,SDS)和症状自评量表(self reporting inventory,SCL-90)评分均显著降低,且联合干预组低于营养干预组(P<0.05);联合干预组的不良反应总发生率(16.00%)与营养干预组(9.33%)比较差异无统计学意义(P>0.05)。结论二甲双胍联合个体化营养干预可有效提升青少年肥胖患者的减肥效果,改善其心理健康状态,且安全性较高。

Objective To investigate the effect of metformin combined with individualized nutritional intervention on weight loss and to explore the safety and mental health in adolescent obese patients.Methods 150 adolescent obese patients were randomly divided into 2 groups using a random number table method(nutritional intervention group and combined intervention group,with 75 cases in each group).The patients in the nutrition intervention group were given individualized nutrition intervention,and the patients in the com‐bined intervention group were given oral Metformin Hydrochloride Tablets on the basis of the individualized nutrition intervention.All patients were intervened for 36 weeks.The weight loss effect,mental health status and adverse reactions of the 2 groups were compared and analyzed.Results After the intervention,the body shapes of both groups were obviously improved,and the combined intervention group was better than the nutrition intervention group(P<0.05);after the intervention,the body weight,body mass index(BMI),body fat rate,the levels of serum fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c)and triglyceride(TG),the scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS),and self-rating symptom scale(SCL-90)in the 2 groups were obviously decreased,and the combined intervention group were lower than the nutrition intervention group(P<0.05);there was no obvious difference in the total incidence of adverse reactions between the combined intervention group and the nutrition intervention group(16.00%vs.9.33%)(P>0.05).Conclusion Metformin combined with individualized nutritional intervention can effectively enhance the weight loss effect in adolescent obese patients and ameliorate their mental health status,with high safety.