Gizem ATAKUL, Hale TUHAN, Ayhan ABACI, Ece BÖBER

İnsülin Direnci olan Obez çocuklarda Metformin Tedavisinin Etkinliği

GİRİŞ ve AMAÇ: Obezite ve insülin direnci, yol açtığı bozukluklar nedeniyle pediatrik endokrinolojinin yanı sıra genel toplum sağlığının önemli bir sorunudur. Bilinen eski bir oral antidiyabetik olan Metforminin obez ve insülin direnci olan çocuklarda kullanımı her geçen gün yaygınlaşmaktadır Bu çalışmada kliniğimizde obezite ve insülin direnci için metformin tedavisi alan olguların tedavi öncesi ve sonrası antropometrik ve metabolik parametreleri karşılaştırılarak tedavi etkinliğinin değerlendirilmesi amaçlanmıştır. YÖNTEM ve GEREÇLER: Dokuz Eylül Üniversitesi Tıp Fakültesi Çocuk Endokrinoloji Bilim Dalında 2005-2015 yılları arasında obezite ve insülin direnci nedeniyle Metformin tedavisi alan 36 olgunun tedavi öncesi ve sonrasındaki antropometrik ve metabolik verileri karşılaştırılarak tedavi etkinliği incelendi. BULGULAR: Olgularda tedavinin 6. Ayında ağırlık SDS (Standart Deviasyon Skoru) (ort. 2.29’dan 1.8’e), VKİ (vücut kitle indeksi) (ort. 31.3kg/m2 den 29.8kg/m2 ye) ve VKİ SDS (ort 2.2’den 1.9’a) değerlerinde istatistiksel olarak anlamlı düşüş (p<0,001); VKİ değerinde 2.41±1.93kg/m2 düşüş saptandı (p<0,001). Tedavi sonrasında açlık insülin, glukoz/insülin oranı; HOMA-IR ve QUICK indeksinde istatistiksel olarak anlamlı düzelme saptandı (p<0,05). TARTIŞMA ve SONUÇ: Metformin, obezite ve insülin direnci olan hastalarda 6 aylık tedavide ciddi yan etki olmaksızın ağırlık SDS, VKİ ve VKİ SDS değerlerinde ve bazı metabolik parametrelerde düzelme sağlamıştır.

Anahtar Kelimeler:

adölesan, insülin direnci, metformin, obezite

Efficacy of Metformin Therapy in Obese Children with Insulin Resistance

INTRODUCTION: Obesity and insulin resistance is an important problem of general public health as well as pediatric endocrinology due to the disorders it causes. Metformin, a well-known oral antidiabetic, is increasingly being a common choice in treatment of obese and insulin resistant children. In this study, it was aimed to retrospectively evaluate the subjects who used metformin treatment due to insulin resistance and exogenous obesity in our clinic and to assess the effects of metformin on anthropometric and metabolic variables. METHODS: The medical records of the 36 patients, who were started metformin therapy due to obesity and insulin resistance and were followed-up in the Pediatric Endocrinology Department of Dokuz Eylül University Medical Faculty between 2005-2015, were retrospectively evaluated. The anthropometric and metabolic variables of these individuals at the sixth month of treatment were compared with basal values. RESULTS: Statistically significant decrease was detected after six months of metformin treatment in weight SDS (Standard Deviation Score) (mean 2.29 to 1.8), BMI (mean 31.3kg/m2 to 29.8kg/m2), and BMI SDS (mean 2.2 to 1.9) (p<0.001). A mean reduction of 2.41±1.93kg/m2 was present in BMI values of study subjects (p<0.001). Statistically significant reductions were found in post-treatment fasting insulin, fasting glucose/insulin ratio, HOMA-IR and Quick index values (p<0.05). DISCUSSION AND CONCLUSION: Metformin is one of the treatment options in obese adolescents with insulin resistance. In our study, it was observed that improvement in anthropometric measurements and metabolic parameters was achieved without any serious side effects in patients who received metformin treatment.

Keywords:

Adolescent, Insulin resistance, metformin, obesity,

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