title: Metformin therapy to reduce weight gain and visceral adiposity in children and adolescents with neurogenic or myogenic motor deficit.
abstract: The aim of this randomized, placebo-controlled study was to explore the effect of metformin in children with a neurogenic or myogenic motor deficit, who are therefore prone to develop overweight, adiposity, and insulin resistance. Study participants (n = 42) had a mean age of 15.5 yr, a short stature (height -2.4 SD), a relatively high BMI (+1.7 SD), and a high body fat fraction (41.9% or +2.8 SD). Abdominal CT confirmed the high fat mass and disclosed a high fraction of visceral fat. As expected, insulin resistance was increased. As compared to placebo, metformin intake for 6 months exerted an insulin sensitizing effect and lowered weight (mean difference of 2 kg within 6 months, p = 0.007) and BMI (p = 0.016). Weight loss appeared to be primarily due to loss of visceral fat ( approximately 20% vs. placebo; p < 0.0001). Results were similar across diagnostic subgroups. In conclusion, metformin treatment for 6 months was associated with a rise in insulin sensitivity and with a reduction of visceral adiposity in children and adolescents with a primary muscle disorder or with a neural tube defect. These findings suggest that insulin resistance underpins, at least partly, the overweight and visceral adiposity of these patients, who are not necessarily obese.
authors.affiliation: Department of Pediatrics, UZ Leuven, Leuven, Belgium. Kristina.casteels@uzleuven.be
authors.forename: Kristina
authors.initials: K
authors.lastname: Casteels
authors.forename: Steffen
authors.initials: S
authors.lastname: Fieuws
authors.forename: Maria
authors.initials: M
authors.lastname: van Helvoirt
authors.forename: Carla
authors.initials: C
authors.lastname: Verpoorten
authors.forename: Nathalie
authors.initials: N
authors.lastname: Goemans
authors.forename: Walter
authors.initials: W
authors.lastname: Coudyzer
authors.forename: Dirk
authors.initials: D
authors.lastname: Loeckx
authors.forename: Francis
authors.initials: F
authors.lastname: de Zegher
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000187:drug effects; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D050152:Intra-Abdominal Fat / Q000187:drug effects*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D020388:Muscular Dystrophy, Duchenne / Q000188:drug therapy*; D009765:Obesity / Q000188:drug therapy; D016135:Spinal Dysraphism / Q000188:drug therapy*; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin