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


Autoři: Judit Bassols aff001;  José-María Martínez-Calcerrada aff001;  Inés Osiniri aff002;  Ferran Díaz-Roldán aff003;  Silvia Xargay-Torrent aff004;  Berta Mas-Parés aff001;  Estefanía Dorado-Ceballos aff003;  Anna Prats-Puig aff005;  Gemma Carreras-Badosa aff004;  Francis de Zegher aff006;  Lourdes Ibáñez aff007;  Abel López-Bermejo aff003
Působiště autorů: Maternal-Fetal Metabolic Group, [Girona Biomedical Research Institute] IDIBGI, Salt, Spain aff001;  Clinical Laboratory, Salut Empordà Foundation, Figueres, Spain aff002;  Pediatrics, Dr. Trueta University Hospital, Girona, Spain aff003;  Pediatric Endocrinology Group, [Girona Biomedical Research Institute] IDIBGI, Salt, Spain aff004;  Department of Physical Therapy, EUSES University School, University of Girona, Girona, Spain aff005;  Department of Development & Regeneration, University of Leuven, Leuven, Belgium aff006;  Endocrinology, Pediatric Research Institute, Sant Joan de Déu Children’s Hospital, Barcelona, Spain aff007;  [Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders] CIBERDEM, ISCIII, Madrid, Spain aff008
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226303

Souhrn

Background

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.

Methods

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.

Results

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.

Conclusion

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.

Klíčová slova:

Adiponectin – Body Mass Index – Fats – Childhood obesity – Insulin – leptin – Magnetic resonance imaging – Metabolic syndrome


Zdroje

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