Metformin therapy to reduce weight gain and visceral adiposity in children and adolescents with neurogenic or myogenic motor deficit.
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.
Casteels
Kristina
K
Department of Pediatrics, UZ Leuven, Leuven, Belgium. Kristina.casteels@uzleuven.be
Fieuws
Steffen
S
van Helvoirt
Maria
M
Verpoorten
Carla
C
Goemans
Nathalie
N
Coudyzer
Walter
W
Loeckx
Dirk
D
de Zegher
Francis
F
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*
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D008687:Metformin