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document
Short-term metabolic and cardiovascular effects of metformin in markedly obese adolescents with normal glucose tolerance . 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 .
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Intervention_Pharmacological
metformin
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Intervention_Pharmacological
metformin
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Intervention_Control
placebo
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Intervention_Control
placebo
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Outcome_Other
Short-term metabolic and cardiovascular effects
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Outcome_Physical
body mass index ( BMI )
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Outcome_Physical
BMI
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Outcome_Physical
subcutaneous fat
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Outcome_Physical
deep subcutaneous fat
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Outcome_Physical
insulin sensitivity ( WBISI )
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Outcome_Physical
insulin sensitivity
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Outcome_Physical
inflammatory cytokines
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Outcome_Physical
lipid parameters
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Outcome_Physical
cardiovascular function
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Outcome_Physical
heart rate recovery
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Outcome_Other
tolerated
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Outcome_Physical
insulin sensitivity
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Outcome_Physical
cardio-metabolic consequences of adolescent obesity
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Participant_Age
adolescents
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Participant_Condition
normal glucose tolerance
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Participant_Condition
obese [ mean body mass index ( BMI ) : 40.3 +/- 5.7 kg/m ( 2 )
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Participant_Condition
insulin-resistant [ homeostasis model assessment - insulin resistance : 7.6 +/- 2.8
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Participant_Condition
whole body insulin sensitivity index ( WBISI ) : 1.5 +/- 0.7 ]
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Participant_Age
15.0 +/- 1.3 yr
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Participant_Condition
randomized to MET ( n = 15 , dose 1500 mg daily ) or placebo (
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Participant_Condition
obese
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Participant_Condition
NGT