Abstract: Abstract: Objective To investigate the clinical effect of metformin combined with lifestyle intervention in obese children with hyperinsulinemia. Methods A total of 82 obese children treated in the Department of Pediatric endocrine of our hospital from January 2015 to December 2016 were selected in this study. All of them were diagnosed as hyperinsulinemia. All cases were treated with metformin in addition to lifestyle guide to adjust their dietary structure and enhance exercise for one year. Clinical anthropometric indicators including height, weight, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and waist-height ratio (WHtR) were measured before treatment and 3 months, 6 months and 12 months after treatment. Blood biochemical indexes were compared before and after treatment with metformin. Results (1) After 12 months of metformin treatment, BMI, WC, WHR and WHtR were all decreased compared with those before treatment. (2) The insulin levels were decreased significantly at all time points in 6 months compared with those before treatment. Levels of FINS, 1 h-INS and 2 h-INS were further reduced after 12-month treatment (P＜0.05). (3) After 6 months of metformin treatment, insulin resistance index (HOMA-IR), function of pancreatic beta-cell (HOMA-β) and area under curve of insulin were decreased whereas the whole body insulin sensitivity index (WBISI) increased (P＜ 0.05). The value of HOMA-IR continued to decline and WBISI continued to rise after 12-month treatment (P＜0.05). There was no significant difference in first-phase insulin secretion index (ΔI30/ΔG30) before and after treatment. Conclusion On the basis of adjusting the diet structure and strengthening the exercise, metformin can reduce BMI, improve insulin sensitivity and reduce insulin resistance in children with hyperinsulinemia.

Key words: metformin, hyperinsulinism, obesity, child, insulin resistance