Journal Article

Effects of metformin administration on endocrine-metabolic parameters, visceral adiposity and cardiovascular risk factors in children with obesity and risk markers for metabolic syndrome: A pilot study

Mas-Parés, Berta, Díaz-Roldán, Ferran, Carreras-Badosa, Gemma, López-Bermejo, Abel, Osiniri, Inés, Xargay-Torrent, Silvia, Prats-Puig, Anna, Bassols, Judit, de Zegher, Francis, Ibáñez, Lourdes, Martínez-Calcerrada, José-María, Dorado-Ceballos, Estefanía

2019

Overview

Metformin treatment (1000-2000 mg/day) over 6 months in pubertal children and/or adolescents with obesity and hyperinsulinism is associated with a reduction in body mass index (BMI) and the insulin resistance index (HOMA-IR). We aimed to ascertain if long-term treatment (24 months) with lower doses of metformin (850 mg/day) normalizes the endocrine-metabolic abnormalities, improves body composition, and reduces the carotid intima-media thickness (cIMT) in pre-puberal and early pubertal children with obesity. A pilot double-blind, placebo-controlled trial was conducted on 18 pre-puberal and early pubertal (Tanner stage I-II) children with obesity and risk markers for metabolic syndrome. Patients were randomly assigned (1:1) to receive metformin (850 mg/day) or placebo for 24 months. Clinical, biochemical (insulin, lipids, leptin, and high-sensitivity C-reactive protein [hsCRP]), and imaging (body composition [dual-energy X-ray absorptiometry and magnetic resonance imaging]) parameters as well as cIMT (ultrasonography) were assessed at baseline and at 6, 12, and 24 months. The 12-month treatment tend to cause a reduction in weight standard deviation scores (SDS), BMI-SDS, leptin, leptin-to-high-molecular-weight (HMW) adiponectin ratio, hsCRP, cIMT, fat mass, and liver fat in metformin-treated children compared with placebo. The effect of metformin on the reduction of BMI-SDS, leptin, leptin-to-HMW adiponectin ratio, hsCRP, and liver fat seemed to be maintained after completing the 24 months of treatment. No changes in insulin sensitivity (HOMA-IR) or adverse effects were detected. In this pilot study, metformin treatment in pre-puberal and early pubertal children with obesity seemed to improve body composition and inflammation markers. Our data encourage the development of future fully powered trials using 850 mg/day metformin in young children, highlighting its excellent tolerance and potential long-term benefits.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Abnormalities / Adiponectin / Adipose tissue / Adolescent / Adolescent obesity / Adolescents / Antidiabetics / Biology and Life Sciences / Body composition / Body fat / Body mass / Body Mass Index / Body size / Body Weight / C-reactive protein / C-Reactive Protein - analysis / Cardiovascular diseases / Carotid Intima-Media Thickness / Child / Child health / Childhood obesity / Children / Clinical trials / Diabetes therapy / Diagnostic imaging / Double-Blind Method / Dual energy X-ray absorptiometry / European Continental Ancestry Group / Female / Health risks / Humans / Hyperinsulinism - blood / Hyperinsulinism - drug therapy / Hypoglycemic agents / Insulin / Insulin - blood / Insulin resistance / Kinases / Leptin / Leptin - blood / Lipids / Liver / Magnetic resonance / Magnetic resonance imaging / Male / Markers / Medical research / Medicine and Health Sciences / Metabolic disorders / Metabolic syndrome / Metabolic Syndrome - blood / Metformin / Metformin - pharmacology / Metformin - therapeutic use / Nutrition / Obesity / Obesity - blood / Obesity - drug therapy / Parameters / Physiological aspects / Pilot Projects / Puberty / Research and Analysis Methods / Retirement benefits / Risk analysis / Risk factors / Sensitivity / Spain / Teenagers / Type 2 diabetes / Ultrasound / Ultrasound imaging / Weight reduction