{"title":"糖尿病母亲在孕期服用二甲双胍对后代（5-11 岁）的长期影响：系统回顾和荟萃分析。","authors":"","doi":"10.1016/j.eprac.2024.05.017","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p><span>Data are scant on the impact of metformin<span> use in gestational diabetes mellitus/diabetes in pregnancy on long-term outcomes in children and mothers beyond 5 years of childbirth. This </span></span>systematic review<span> and meta-analysis aimed to evaluate the long-term impact of metformin use in pregnancy on children and their mothers.</span></p></div><div><h3>Methods</h3><p>Electronic databases were searched for studies evaluating metformin compared with insulin for managing gestational diabetes mellitus/diabetes in pregnancy. The primary outcome was the change in body mass index<span> (BMI) in children at the ages of 5 to 11 years. The secondary outcomes were alterations in other anthropometric<span><span> measures, obesity, and changes in the levels of lipids and </span>adipocytokines in children and mothers.</span></span></p></div><div><h3>Results</h3><p>Children at the age of 9 years born to mothers who were treated with metformin during pregnancy had similar BMI (mean difference [MD], 1.09 kg/m<sup>2</sup> [95% confidence interval {CI}, −0.44 to 2.62]; <em>P</em> = .16; I<sup>2</sup> = 16%), waist circumference-to-height ratio (MD, 0.13 [95% CI, −0.05 to 0.30]; <em>P</em> = .16; I<sup>2</sup><span> = 94%), dual-energy X-ray absorptiometry (DXA) total fat mass (MD, 0.68 kg [95% CI, −2.39 to 3.79]; </span><em>P</em> = .66; I<sup>2</sup> = 70%), DXA total fat percent (MD, 0.04% [95% CI, −3.44 to 3.51]; <em>P</em> = .98; I<sup>2</sup> = 56%), DXA total fat-free mass (MD, 0.81 kg [95% CI, −0.96 to 2.58]; <em>P</em> = .37; I<sup>2</sup><span> = 55%), magnetic resonance imaging visceral adipose tissue volume (MD, 80.97 cm</span><sup>3</sup> [95% CI, −136.47 to 298.41]; <em>P</em> = .47; I<sup>2</sup><span><span> = 78%), and magnetic resonance spectroscopy </span>liver fat percentage (MD, 0.27% [95% CI, −1.26 to 1.79]; </span><em>P</em> = .73; I<sup>2</sup><span><span><span> = 0%) to those born to mothers who were treated with insulin. Serum adiponectin, leptin, </span>alanine aminotransferase, and </span>ferritin<span> were comparable among groups. In children between the ages of 9 and 11 years, the occurrence of obesity, diabetes, or challenges in motor and social development were comparable between the 2 groups. After 9 years of childbirth, BMI and the risk of developing diabetes were similar between the 2 groups of women.</span></span></p></div><div><h3>Conclusion</h3><p>Metformin use in pregnancy did not show any adverse effects compared with insulin on long-term outcomes in children and their mothers.</p></div>","PeriodicalId":11682,"journal":{"name":"Endocrine Practice","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-Term Impact on Offspring (5 to 11 Years of Age) of Metformin Use in Pregnancy in Mothers With Diabetes: A Systematic Review and Meta-Analysis\",\"authors\":\"\",\"doi\":\"10.1016/j.eprac.2024.05.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><p><span>Data are scant on the impact of metformin<span> use in gestational diabetes mellitus/diabetes in pregnancy on long-term outcomes in children and mothers beyond 5 years of childbirth. This </span></span>systematic review<span> and meta-analysis aimed to evaluate the long-term impact of metformin use in pregnancy on children and their mothers.</span></p></div><div><h3>Methods</h3><p>Electronic databases were searched for studies evaluating metformin compared with insulin for managing gestational diabetes mellitus/diabetes in pregnancy. The primary outcome was the change in body mass index<span> (BMI) in children at the ages of 5 to 11 years. The secondary outcomes were alterations in other anthropometric<span><span> measures, obesity, and changes in the levels of lipids and </span>adipocytokines in children and mothers.</span></span></p></div><div><h3>Results</h3><p>Children at the age of 9 years born to mothers who were treated with metformin during pregnancy had similar BMI (mean difference [MD], 1.09 kg/m<sup>2</sup> [95% confidence interval {CI}, −0.44 to 2.62]; <em>P</em> = .16; I<sup>2</sup> = 16%), waist circumference-to-height ratio (MD, 0.13 [95% CI, −0.05 to 0.30]; <em>P</em> = .16; I<sup>2</sup><span> = 94%), dual-energy X-ray absorptiometry (DXA) total fat mass (MD, 0.68 kg [95% CI, −2.39 to 3.79]; </span><em>P</em> = .66; I<sup>2</sup> = 70%), DXA total fat percent (MD, 0.04% [95% CI, −3.44 to 3.51]; <em>P</em> = .98; I<sup>2</sup> = 56%), DXA total fat-free mass (MD, 0.81 kg [95% CI, −0.96 to 2.58]; <em>P</em> = .37; I<sup>2</sup><span> = 55%), magnetic resonance imaging visceral adipose tissue volume (MD, 80.97 cm</span><sup>3</sup> [95% CI, −136.47 to 298.41]; <em>P</em> = .47; I<sup>2</sup><span><span> = 78%), and magnetic resonance spectroscopy </span>liver fat percentage (MD, 0.27% [95% CI, −1.26 to 1.79]; </span><em>P</em> = .73; I<sup>2</sup><span><span><span> = 0%) to those born to mothers who were treated with insulin. Serum adiponectin, leptin, </span>alanine aminotransferase, and </span>ferritin<span> were comparable among groups. In children between the ages of 9 and 11 years, the occurrence of obesity, diabetes, or challenges in motor and social development were comparable between the 2 groups. After 9 years of childbirth, BMI and the risk of developing diabetes were similar between the 2 groups of women.</span></span></p></div><div><h3>Conclusion</h3><p>Metformin use in pregnancy did not show any adverse effects compared with insulin on long-term outcomes in children and their mothers.</p></div>\",\"PeriodicalId\":11682,\"journal\":{\"name\":\"Endocrine Practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrine Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1530891X24005597\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine Practice","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1530891X24005597","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Long-Term Impact on Offspring (5 to 11 Years of Age) of Metformin Use in Pregnancy in Mothers With Diabetes: A Systematic Review and Meta-Analysis
Objective
Data are scant on the impact of metformin use in gestational diabetes mellitus/diabetes in pregnancy on long-term outcomes in children and mothers beyond 5 years of childbirth. This systematic review and meta-analysis aimed to evaluate the long-term impact of metformin use in pregnancy on children and their mothers.
Methods
Electronic databases were searched for studies evaluating metformin compared with insulin for managing gestational diabetes mellitus/diabetes in pregnancy. The primary outcome was the change in body mass index (BMI) in children at the ages of 5 to 11 years. The secondary outcomes were alterations in other anthropometric measures, obesity, and changes in the levels of lipids and adipocytokines in children and mothers.
Results
Children at the age of 9 years born to mothers who were treated with metformin during pregnancy had similar BMI (mean difference [MD], 1.09 kg/m2 [95% confidence interval {CI}, −0.44 to 2.62]; P = .16; I2 = 16%), waist circumference-to-height ratio (MD, 0.13 [95% CI, −0.05 to 0.30]; P = .16; I2 = 94%), dual-energy X-ray absorptiometry (DXA) total fat mass (MD, 0.68 kg [95% CI, −2.39 to 3.79]; P = .66; I2 = 70%), DXA total fat percent (MD, 0.04% [95% CI, −3.44 to 3.51]; P = .98; I2 = 56%), DXA total fat-free mass (MD, 0.81 kg [95% CI, −0.96 to 2.58]; P = .37; I2 = 55%), magnetic resonance imaging visceral adipose tissue volume (MD, 80.97 cm3 [95% CI, −136.47 to 298.41]; P = .47; I2 = 78%), and magnetic resonance spectroscopy liver fat percentage (MD, 0.27% [95% CI, −1.26 to 1.79]; P = .73; I2 = 0%) to those born to mothers who were treated with insulin. Serum adiponectin, leptin, alanine aminotransferase, and ferritin were comparable among groups. In children between the ages of 9 and 11 years, the occurrence of obesity, diabetes, or challenges in motor and social development were comparable between the 2 groups. After 9 years of childbirth, BMI and the risk of developing diabetes were similar between the 2 groups of women.
Conclusion
Metformin use in pregnancy did not show any adverse effects compared with insulin on long-term outcomes in children and their mothers.
期刊介绍：
Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.
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