The Lancet Diabetes & Endocrinology：二甲双胍不应被用来改善无糖尿病的肥胖女性的妊娠结局

2015-07-10 崔倩译 MedSci原创

产妇肥胖与婴儿体重上升相关，而肥胖又与成年子女过早死亡有关。母体肥胖导致这些结果的机制还不是很清楚，但产妇的高血糖是和胰岛素抵抗密切相关的。该研究目的是研究胰岛素增敏药物二甲双胍是否能改善无糖尿病但肥胖的孕妇和胎儿的结局。       研究人员在英国15个国家的卫生服务医院的产前检查诊所做了这项随机、双盲、安慰剂对照试验。参与者为12和16周妊娠期

产妇肥胖与婴儿体重上升相关，而肥胖又与成年子女过早死亡有关。母体肥胖导致这些结果的机制还不是很清楚，但产妇的高血糖是和胰岛素抵抗密切相关的。该研究目的是研究胰岛素增敏药物二甲双胍是否能改善无糖尿病但肥胖的孕妇和胎儿的结局。

研究人员在英国15个国家的卫生服务医院的产前检查诊所做了这项随机、双盲、安慰剂对照试验。参与者为12和16周妊娠期间的孕妇（年龄≥16岁）的BMI为30公斤/平方米以上，并有正常糖耐受量，由基于网络的计算机生成的块随机化过程（两到四个块大小）被随机分配（1：1）接受口服二甲双胍500mg（增加至最高2500mg），或接受每日匹配的安慰剂，从12周和16周妊娠期开始直至婴儿分娩。通过研究地点和BMI随机进行分层（30-39 vs ≥40kg/m2）。参加者，照顾者和研究人员都不知道治疗分配。主要成果是相对应的孕周，奇偶校验，并在24周以上妊娠分娩的活产婴儿性别标准化出生体重百分位的Z值。通过修改意向性治疗进行分析。

在2011年2月3日和2014年1月16日之间，研究人员随机分配449名女性服用安慰剂（n=223）或二甲双胍（n=226），其中434名（97％）被列入最后的修改意向——处理分析。分娩时的平均体重安慰剂组为3463克（SD 660），二甲双胍组为3462克（548）。二甲双胍对主要成果的估计影响的大小是不显著的（调整后的平均差异-0.029，95％Cl -0.217-0.158，P=0.7597）。在报告流产、终止妊娠、死胎、或新生儿死亡的不良结果在两组中差异不明显，二甲双胍组（n=7） vs 安慰剂组（n=2）（OR 3.60，95％Cl 0.74-17.50；P=0.11）。

二甲双胍对肥胖孕妇的婴儿体重百分位影响不显著。在EMPOWaR研究中还将进一步对出生的婴儿随访以确定在这一人群中二甲双胍的长期影响；在此期间，二甲双胍不应被用来改善没有糖尿病肥胖女性的妊娠结局。

原始出处：

Carolyn Chiswick, Prof Rebecca M Reynolds, Fiona Denison, Amanda J Drake, et al.Effect of metformin on maternal and fetal outcomes in obese pregnant women (EMPOWaR),The Lancet Diabetes & Endocrinology.2015.7.9javascript:void(0);/*1436497490142*/

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2015-09-02 木头人513

#Diabetes#

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2016-05-12 howi

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2016-05-19 ms9608593228839890

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2016-05-28 12498c32m68暂无昵称

#Endocrinology#

45 0
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authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Wed Jul 29 23:09:00 CST 2015, time=2015-07-29, status=1, ipAttribution=)]
2015-11-03 licz0423

#肥胖女性#

54 0
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authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Wed Jul 29 23:09:00 CST 2015, time=2015-07-29, status=1, ipAttribution=)]
2015-07-28 zm0805

哦

114 0
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2015, time=2015-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1392901, encodeId=a90a139290179, content=<a href='/topic/show?id=8c9f4492370' target=_blank style='color:#2F92EE;'>#妊娠结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44923, encryptionId=8c9f4492370, topicName=妊娠结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1fa82500120, createdName=12498a1cm67暂无昵称, createdTime=Sun Jul 12 00:09:00 CST 2015, time=2015-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1759569, encodeId=9b5e1e59569ee, content=<a href='/topic/show?id=9bea33520d' target=_blank style='color:#2F92EE;'>#BET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=22, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3352, encryptionId=9bea33520d, topicName=BET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Wed Jul 29 23:09:00 CST 2015, time=2015-07-29, status=1, ipAttribution=)]
2015-07-28 shuaijing1986

第一次听说

110 0
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2015-07-12 huaxipanxing

看看

108 0
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2015-07-12 12498a1cm67暂无昵称

#妊娠结局#

31 0
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authenticateStatus=null, createdAvatar=null, createdBy=9a1a37427546, createdName=ms5439512287675881, createdTime=Wed Jul 29 23:09:00 CST 2015, time=2015-07-29, status=1, ipAttribution=)]
2015-07-29 ms5439512287675881

#BET#

22 0

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The Lancet Diabetes & Endocrinology：二甲双胍不应被用来改善无糖尿病的肥胖女性的妊娠结局

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