Cargando…

Effects of Metformin on Body Weight and Body Composition in Obese Insulin-Resistant Children: A Randomized Clinical Trial

OBJECTIVE: Metformin can decrease adiposity and ameliorate obesity-related comorbid conditions, including abnormalities in glucose homeostasis in adolescents, but there are few data evaluating the efficacy of metformin among younger children. Our objective was to determine whether metformin treatmen...

Descripción completa

Detalles Bibliográficos
Autores principales: Yanovski, Jack A., Krakoff, Jonathan, Salaita, Christine G., McDuffie, Jennifer R., Kozlosky, Merel, Sebring, Nancy G., Reynolds, James C., Brady, Sheila M., Calis, Karim A.
Formato: Texto
Lenguaje:English
Publicado: American Diabetes Association 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028347/
https://www.ncbi.nlm.nih.gov/pubmed/21228310
http://dx.doi.org/10.2337/db10-1185
_version_ 1782197168293019648
author Yanovski, Jack A.
Krakoff, Jonathan
Salaita, Christine G.
McDuffie, Jennifer R.
Kozlosky, Merel
Sebring, Nancy G.
Reynolds, James C.
Brady, Sheila M.
Calis, Karim A.
author_facet Yanovski, Jack A.
Krakoff, Jonathan
Salaita, Christine G.
McDuffie, Jennifer R.
Kozlosky, Merel
Sebring, Nancy G.
Reynolds, James C.
Brady, Sheila M.
Calis, Karim A.
author_sort Yanovski, Jack A.
collection PubMed
description OBJECTIVE: Metformin can decrease adiposity and ameliorate obesity-related comorbid conditions, including abnormalities in glucose homeostasis in adolescents, but there are few data evaluating the efficacy of metformin among younger children. Our objective was to determine whether metformin treatment causes weight loss and improves obesity-related comorbidities in obese children, who are insulin-resistant. RESEARCH DESIGN AND METHODS: This study was a randomized double-blind placebo-controlled trial consisting of 100 severely obese (mean BMI 34.6 ± 6.6 kg/m(2)) insulin-resistant children aged 6–12 years, randomized to 1,000 mg metformin (n = 53) or placebo (n = 47) twice daily for 6 months, followed by open-label metformin treatment for 6 months. All children and their parents participated in a monthly dietitian-administered weight-reduction program. RESULTS: Eighty-five percent completed the 6-month randomized phase. Children prescribed metformin had significantly greater decreases in BMI (difference −1.09 kg/m(2), CI −1.87 to −0.31, P = 0.006), body weight (difference −3.38 kg, CI −5.2 to −1.57, P < 0.001), BMI Z score (difference between metformin and placebo groups −0.07, CI −0.12 to −0.01, P = 0.02), and fat mass (difference −1.40 kg, CI −2.74 to −0.06, P = 0.04). Fasting plasma glucose (P = 0.007) and homeostasis model assessment (HOMA) insulin resistance index (P = 0.006) also improved more in metformin-treated children than in placebo-treated children. Gastrointestinal symptoms were significantly more prevalent in metformin-treated children, which limited maximal tolerated dosage in 17%. During the 6-month open-label phase, children treated previously with placebo decreased their BMI Z score; those treated continuously with metformin did not significantly change BMI Z score further. CONCLUSIONS: Metformin had modest but favorable effects on body weight, body composition, and glucose homeostasis in obese insulin-resistant children participating in a low-intensity weight-reduction program.
format Text
id pubmed-3028347
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher American Diabetes Association
record_format MEDLINE/PubMed
spelling pubmed-30283472012-02-01 Effects of Metformin on Body Weight and Body Composition in Obese Insulin-Resistant Children: A Randomized Clinical Trial Yanovski, Jack A. Krakoff, Jonathan Salaita, Christine G. McDuffie, Jennifer R. Kozlosky, Merel Sebring, Nancy G. Reynolds, James C. Brady, Sheila M. Calis, Karim A. Diabetes Obesity Studies OBJECTIVE: Metformin can decrease adiposity and ameliorate obesity-related comorbid conditions, including abnormalities in glucose homeostasis in adolescents, but there are few data evaluating the efficacy of metformin among younger children. Our objective was to determine whether metformin treatment causes weight loss and improves obesity-related comorbidities in obese children, who are insulin-resistant. RESEARCH DESIGN AND METHODS: This study was a randomized double-blind placebo-controlled trial consisting of 100 severely obese (mean BMI 34.6 ± 6.6 kg/m(2)) insulin-resistant children aged 6–12 years, randomized to 1,000 mg metformin (n = 53) or placebo (n = 47) twice daily for 6 months, followed by open-label metformin treatment for 6 months. All children and their parents participated in a monthly dietitian-administered weight-reduction program. RESULTS: Eighty-five percent completed the 6-month randomized phase. Children prescribed metformin had significantly greater decreases in BMI (difference −1.09 kg/m(2), CI −1.87 to −0.31, P = 0.006), body weight (difference −3.38 kg, CI −5.2 to −1.57, P < 0.001), BMI Z score (difference between metformin and placebo groups −0.07, CI −0.12 to −0.01, P = 0.02), and fat mass (difference −1.40 kg, CI −2.74 to −0.06, P = 0.04). Fasting plasma glucose (P = 0.007) and homeostasis model assessment (HOMA) insulin resistance index (P = 0.006) also improved more in metformin-treated children than in placebo-treated children. Gastrointestinal symptoms were significantly more prevalent in metformin-treated children, which limited maximal tolerated dosage in 17%. During the 6-month open-label phase, children treated previously with placebo decreased their BMI Z score; those treated continuously with metformin did not significantly change BMI Z score further. CONCLUSIONS: Metformin had modest but favorable effects on body weight, body composition, and glucose homeostasis in obese insulin-resistant children participating in a low-intensity weight-reduction program. American Diabetes Association 2011-02 2011-01-21 /pmc/articles/PMC3028347/ /pubmed/21228310 http://dx.doi.org/10.2337/db10-1185 Text en © 2011 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
spellingShingle Obesity Studies
Yanovski, Jack A.
Krakoff, Jonathan
Salaita, Christine G.
McDuffie, Jennifer R.
Kozlosky, Merel
Sebring, Nancy G.
Reynolds, James C.
Brady, Sheila M.
Calis, Karim A.
Effects of Metformin on Body Weight and Body Composition in Obese Insulin-Resistant Children: A Randomized Clinical Trial
title Effects of Metformin on Body Weight and Body Composition in Obese Insulin-Resistant Children: A Randomized Clinical Trial
title_full Effects of Metformin on Body Weight and Body Composition in Obese Insulin-Resistant Children: A Randomized Clinical Trial
title_fullStr Effects of Metformin on Body Weight and Body Composition in Obese Insulin-Resistant Children: A Randomized Clinical Trial
title_full_unstemmed Effects of Metformin on Body Weight and Body Composition in Obese Insulin-Resistant Children: A Randomized Clinical Trial
title_short Effects of Metformin on Body Weight and Body Composition in Obese Insulin-Resistant Children: A Randomized Clinical Trial
title_sort effects of metformin on body weight and body composition in obese insulin-resistant children: a randomized clinical trial
topic Obesity Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028347/
https://www.ncbi.nlm.nih.gov/pubmed/21228310
http://dx.doi.org/10.2337/db10-1185
work_keys_str_mv AT yanovskijacka effectsofmetforminonbodyweightandbodycompositioninobeseinsulinresistantchildrenarandomizedclinicaltrial
AT krakoffjonathan effectsofmetforminonbodyweightandbodycompositioninobeseinsulinresistantchildrenarandomizedclinicaltrial
AT salaitachristineg effectsofmetforminonbodyweightandbodycompositioninobeseinsulinresistantchildrenarandomizedclinicaltrial
AT mcduffiejenniferr effectsofmetforminonbodyweightandbodycompositioninobeseinsulinresistantchildrenarandomizedclinicaltrial
AT kozloskymerel effectsofmetforminonbodyweightandbodycompositioninobeseinsulinresistantchildrenarandomizedclinicaltrial
AT sebringnancyg effectsofmetforminonbodyweightandbodycompositioninobeseinsulinresistantchildrenarandomizedclinicaltrial
AT reynoldsjamesc effectsofmetforminonbodyweightandbodycompositioninobeseinsulinresistantchildrenarandomizedclinicaltrial
AT bradysheilam effectsofmetforminonbodyweightandbodycompositioninobeseinsulinresistantchildrenarandomizedclinicaltrial
AT caliskarima effectsofmetforminonbodyweightandbodycompositioninobeseinsulinresistantchildrenarandomizedclinicaltrial