title: Systematic review of metformin use in obese nondiabetic children and adolescents.
abstract: OBJECTIVE
  Childhood obesity has become epidemic and has been accompanied by an increase in prevalence of type 2 diabetes (T2DM) in youth. Addressing obesity and insulin resistance by drug treatment represents a rational strategy for the prevention of T2DM. A systematic review was performed to evaluate the effectiveness of metformin in reducing weight and ameliorating insulin resistance in obese nondiabetic children.
  
  
  METHODS
  A PubMed database search was conducted, using 'metformin', 'obesity', 'insulin resistance', 'children', 'adolescents' as search terms.
  
  
  RESULTS
  Eleven trials were included in the present review. Metformin was administered for 6-12 months at a dosage of 1,000-2,000 mg/daily, decreasing BMI by 1.1-2.7 compared with placebo or lifestyle intervention alone. Concomitantly, fasting insulin resistance improved after metformin therapy. Posttreatment follow-up was performed in one study, showing that after 1 year of discontinuation of therapy the decrease in BMI disappears.
  
  
  CONCLUSIONS
  Short-term metformin treatment appears to moderately affect weight reduction in severely obese children and adolescents, with a concomitant improvement in fasting insulin sensitivity. Further studies with longer treatment period are needed to establish how much metformin can reduce weight and its real utility in preventing T2DM development in pediatric patients.
authors.affiliation: Endocrinology and Diabetes Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Brufani
authors.forename: Antonino
authors.initials: A
authors.lastname: Crinò
authors.forename: Danilo
authors.initials: D
authors.lastname: Fintini
authors.forename: Patrizia Ippolita
authors.initials: PI
authors.lastname: Patera
authors.forename: Marco
authors.initials: M
authors.lastname: Cappa
authors.forename: Melania
authors.initials: M
authors.lastname: Manco
mesh_terms: D000293:Adolescent; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D006801:Humans; D007333:Insulin Resistance; D008019:Life Style; D008687:Metformin / Q000627:therapeutic use*; D063766:Pediatric Obesity / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
chemical_list: D008687:Metformin