关键词: 高胰岛素血症, 肥胖, 胰岛素抵抗, 脂联素, 抵抗素, 瘦素

Abstract: AbstractObjectiveTo observe effects of metformin on plasma adiponectin,leptin and resistin of hyperinsulinemic children and adolescents. MethodsFiftyfour obese hyperinsulinemic children aged 6~17 years were enrolled in this trial and were divided into two groups:mildmoderate obesity and severe obesity group;fortyfive healthy nonobese children aged 6.5~17 years were as control.The obese hyperinsulinemic children received metformin (175~250 mg twice or thrice daily) for 12 weeks.The plasma concentrations of plasma adiponectin,leptin and resistin were measured at baseline and after 12 weeks of metformin treatment for obesity groups.The fasting plasma glucose and fasting plasma insulin were also measured. ResultsBefore metformin treatment,the HOMAIR and the serum concentrations of insulin,leptin and resistin of the two obese hyperinsulinemic groups were significantly higher,while adiponectin was significantly lower compared with the contral group;there was no significant difference(P>0.05) in serum fasting glucose between obese hyperinsulinemic children and the controls.After 12 weeks of treatment,serum insulin concentrations and insulin resistance index(HOMAIR) decreased(P<0.01);leptin levels decreased (mild and moderate obesity group 24.3±1.8μg/L vs 19.6±6.3μg/L,P<0.05;severe obesity group 30.2±5.1μg/L vs 24.7±5.3μg/L,P<0.01).The plasma resistin levels increased(mild and moderate obesity group 16.5±6.0 μg/L vs 22.0±5.1μg/L,P<0.05;severe obesity group 22.3±5.2μg/L vs 30.6±11.7μg/L,P<0.01).The plasma adiponectin didn't change greatly compared to the before(mild obesity and moderate obesity group 8.9±2.3 mg/L vs 8.4±3.2 mg/L，P>0.05;severe obesity group 7.0±3.0 mg/L vs 6.5±1.2 mg/L,P>0.05). ConclusionThese data collectively suggest that metformin induces attenuation of hyperinsulinemia and insulin resistance in obese hyperinsulinemic children.The decrease of serum leptin levels may contribute to the insulinsensitizing and antihyperglycemia function of metformin.On adipocytokines level,the effect of metformin is limited.

Key words: Adiponectin, Resistin, Leptin, Obesity, Insulin resistance