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Metformin use in children with obesity and normal glucose tolerance--effects on cardiovascular markers and intrahepatic fat.

ABSTRACT: To determine if metformin improves markers of inflammation, thrombosis, and intrahepatic fat contents in children with uncomplicated obesity.Obese children with normal glucose tolerance but elevated highly sensitive C-reactive protein (hsCRP) and/or fibrinogen concentrations (>2 standard deviations) were randomized to structured diet/exercise or diet/exercise and metformin for 6 months. Blood samples, dual energy X-ray absorptiometry data, and liver magnetic resonance images were obtained.Forty-two of 66 recruited children (7-18 years) completed 6 months. Weight loss was modest but more pronounced in the metformin group (-4.9 +/- 1.0 kg) than in the diet/exercise group (-1.7 +/- 1.1 kg, p<0.03), whereas hsCRP and fibrinogen decreased more in the diet/exercise pubertal group. Baseline intrahepatic fat was high but decreased only in the diet/exercise (not metformin) pubertal group.Six months of metformin therapy improved weight loss and reduced abdominal adiposity, but did not enhance the beneficial effect of diet and exercise on markers related to inflammation, thrombosis, or hepatic fat in obese children with normal glucose tolerance.

SUBMITTER: Mauras N

PROVIDER: S-EPMC4005723 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Metformin use in children with obesity and normal glucose tolerance--effects on cardiovascular markers and intrahepatic fat.

Mauras Nelly N DelGiorno Charles C Hossain Jobayer J Bird Keisha K Killen Kelleigh K Merinbaum Debbie D Weltman Arthur A Damaso Ligeia L Balagopal Prabhakaran P

Journal of pediatric endocrinology & metabolism : JPEM 20120101 1-2

<h4>Objective</h4>To determine if metformin improves markers of inflammation, thrombosis, and intrahepatic fat contents in children with uncomplicated obesity.<h4>Methods</h4>Obese children with normal glucose tolerance but elevated highly sensitive C-reactive protein (hsCRP) and/or fibrinogen concentrations (>2 standard deviations) were randomized to structured diet/exercise or diet/exercise and metformin for 6 months. Blood samples, dual energy X-ray absorptiometry data, and liver magnetic res ...[more]

PMID: 22570948

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Project description:INTRODUCTION:The occurrence of cardiovascular diseases and metabolic disorders steadily increases with the body mass index (BMI). Since the latter is not the best and earliest indicator of obesity and cardiovascular risk, the aim of the study was to evaluate some potential biological markers that would allow us to detect children and adolescents at higher risk at an early stage. METHODS:A sample of 330 children and adolescents were included in the study and divided into four groups: obese patients with hypertension, normal-weight patients with hypertension, patients with mildly elevated lipids and a control group of healthy children and adolescents. Some clinical parameters (age, body weight, body height, BMI, waist circumference, hip circumference, blood pressure), biochemical parameters (glucose, total cholesterol, triglycerides, HDL, LDL, apolipoprotein A1, homocysteine) and biological markers of obesity (ghrelin, adiponectin, leptin) were evaluated. RESULTS:Ghrelin and adiponectin were found to have a strong negative statistically significant correlation with BMI in all three observed groups (p?<?0.001), but not in the control group (p?=?0.053 and p?=?0.316, respectively). In addition, leptin had a strong positive statistically significant correlation with BMI in all four groups (p?<?0.001 for the research groups, p?=?0.009 for the controls). In the group of obese patients with hypertension, statistically significant differences in all three markers of obesity were found in comparison to the control group (p?<?0.001 for all markers). In the group of patients with mildly elevated lipids, ghrelin and leptin were significantly different (p?=?0.002 and p?<?0.001, respectively). In the group of normal-weight hypertensive patients, only values of ghrelin were different compared to the control group (p?=?0.001). CONCLUSION:In the research groups, significant differences were found in clinical, biochemical and biological parameters compared to the control group. The observed biological markers of obesity are useful early markers for identifying groups of patients that are at cardiovascular risk.

Dataset Information

Metformin use in children with obesity and normal glucose tolerance--effects on cardiovascular markers and intrahepatic fat.

Publications

Metformin use in children with obesity and normal glucose tolerance--effects on cardiovascular markers and intrahepatic fat.

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