title: Omega-3 polyunsaturated fatty acids reduce insulin resistance and triglycerides in obese children and adolescents.
abstract: BACKGROUND
  Approximately 50% of obese children are insulin resistant. It has been suggested that pharmacological and nutritional options should be considered to improve the management of insulin resistance (IR).
  
  
  OBJECTIVE
  To assess the effect of metformin (Met) or omega-3 (ω-3) polyunsaturated fatty acids (PUFA) on the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index, lipid profile, and body mass index (BMI) of obese children.
  
  
  METHODS
  We included 201 obese and insulin-resistant children and adolescents. Ninety-eight of them received 500 mg of Met, and 103 received 1.8 g of ω-3 PUFA for 12 wk. This was an open-label study with assignment of treatment based on which school the child attended. At the baseline and at the end of study, the following parameters were measured: weight, height, waist circumference, blood pressure, insulin, glucose, lipid profile, and HOMA-IR index. There were no lifestyle interventions.
  
  
  RESULTS
  At baseline, the age, BMI, and IR in children of both groups were comparable. The treatment assigned for each group was well tolerated. Metabolic changes were adjusted for age, sex, and change in BMI. Concerning the IR profile at the end of intervention, ω-3 significantly decreased the concentrations of glucose and insulin while reducing HOMA-IR values; meanwhile, Met negligibly affected insulin levels. Regarding lipids, Met increased high density lipoprotein cholesterol (HDL-C) and decreased low density lipoprotein cholesterol (LDL-C), but triglycerides were not affected; in contrast, triglycerides were decreased significantly by ω-3. The effects on BMI were marginal under Met but were significant with ω-3.
  
  
  CONCLUSIONS
  The results of this work suggest that ω-3 may be useful as an adjuvant therapy in obese children and adolescents with IR.
authors: Department for Innovation and Quality, Institute for Decentralized Public Health Services, INDESALUD, Campeche, Campeche 24040, Mexico.
authors: Carlos
authors: C
authors: Juárez-López
authors: Miguel
authors: M
authors: Klünder-Klünder
authors: Adrián
authors: A
authors: Madrigal-Azcárate
authors: Samuel
authors: S
authors: Flores-Huerta
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015992:Body Mass Index; D002648:Child; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008055:Lipids / Q000097:blood; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008954:Models, Biological; D009765:Obesity / Q000188:drug therapy*; D014280:Triglycerides / Q000097:blood*
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D015525:Fatty Acids, Omega-3; D008055:Lipids; D014280:Triglycerides; D008687:Metformin
keywords: children; insulin resistance; metformin; obesity; omega-3 fatty acids