Premium
Short‐term metabolic and cardiovascular effects of metformin in markedly obese adolescents with normal glucose tolerance
Author(s) -
Burgert Tania S,
Duran Elvira J,
GoldbergGell Rachel,
Dziura James,
Yeckel Catherine W,
Katz Stuart,
Tamborlane William V,
Caprio Sonia
Publication year - 2008
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-5448.2008.00434.x
Subject(s) - medicine , insulin resistance , metformin , insulin , endocrinology , placebo , body mass index , diabetes mellitus , obesity , glucose homeostasis , alternative medicine , pathology
Objective: Although metformin (MET) is an insulin sensitizer currently used as an adjunct to the treatment of some of the complications of childhood obesity besides type 2 diabetes mellitus, few studies have comprehensively examined its metabolic and clinical effects in obese children with normal glucose tolerance (NGT). Methods: We therefore conducted a 4‐month double‐blind clinical trial in 28 obese [mean body mass index (BMI): 40.3 ± 5.7 kg/m 2 ], insulin‐resistant [homeostasis model assessment – insulin resistance: 7.6 ± 2.8 and whole body insulin sensitivity index (WBISI): 1.5 ± 0.7] adolescents (age 15.0 ± 1.3 yr) randomized to MET (n = 15, dose 1500 mg daily) or placebo (n = 13). Results: The treatment with MET was well tolerated. MET treatment was associated with a decreased BMI (p = 0.02) as well as with a reduction in subcutaneous fat (p = 0.03), particularly the deep subcutaneous fat (p = 0.04) as assessed by magnetic resonance imaging. Postintervention, the MET group had a 35% improvement in insulin sensitivity (WBISI) compared with the placebo group (p = 0.008). However, significance was lost with adjustments for differences in baseline insulin sensitivity (p = 0.09). While there was no change in inflammatory cytokines or lipid parameters, cardiovascular function as assessed by heart rate recovery after exercise improved with MET and worsened in placebo (p = 0.03). Conclusion: Short‐term use of MET is well tolerated by obese children with NGT and has a beneficial effect on BMI and autonomic control of the heart as well as a trend toward improved insulin sensitivity. Thus, long‐term treatment with MET may provide a means to ameliorate the cardio‐metabolic consequences of adolescent obesity.