title: Effects of Conjugated Linoleic Acid and Metformin on Insulin Sensitivity in Obese Children: Randomized Clinical Trial.
abstract: Insulin resistance precedes metabolic syndrome abnormalities and may promote cardiovascular disease and type 2 diabetes in children with obesity. Results of lifestyle modification programs have been discouraging, and the use of adjuvant strategies has been necessary.
  
  
  
  This study aimed to evaluate the effects of metformin and conjugated linoleic acid (CLA) on insulin sensitivity, measured via euglycemic-hyperinsulinemic clamp technique and insulin pathway expression molecules in muscle biopsies of children with obesity.
  
  
  
  A randomized, double-blinded, placebo-controlled clinical trial was conducted.
  
  
  
  Children with obesity were randomly assigned to receive metformin, CLA, or placebo.
  
  
  
  Intervention had a positive effect in all groups. For insulin sensitivity Rd value (mg/kg/min), there was a statistically significant difference between the CLA vs placebo (6.53 ± 2.54 vs 5.05 ± 1.46, P = 0.035). Insulinemia and homeostatic model assessment of insulin resistance significantly improved in the CLA group (P = 0.045). After analysis of covariance was performed and the influence of body mass index, age, Tanner stage, prescribed diet, and fitness achievement was controlled, a clinically relevant effect size on insulin sensitivity remained evident in the CLA group (37%) and exceeded lifestyle program benefits. Moreover, upregulated expression of the insulin receptor substrate 2 was evident in muscle biopsies of the CLA group.
  
  
  
  Improvement of insulin sensitivity, measured via euglycemic-hyperinsulinemic clamp and IRS2 upregulation, favored patients treated with CLA.
authors: Children and Adolescent Obesity Clinic.|Department of Human Genetics, Hospital General de México Eduardo Liceaga-Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico.
authors: Nayely
authors: N
authors: Garibay-Nieto
authors: Department of Human Genetics, Hospital General de México Eduardo Liceaga-Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico.
authors: Gloria
authors: G
authors: Queipo-García
authors: Children and Adolescent Obesity Clinic.
authors: Flor
authors: F
authors: Alvarez
authors: Research Unit, and.
authors: Mayra
authors: M
authors: Bustos
authors: Children and Adolescent Obesity Clinic.
authors: Erendira
authors: E
authors: Villanueva
authors: Specialized Center for Diabetes Control, Public Health Services, Mexico City, Mexico 11340.
authors: Fernando
authors: F
authors: Ramírez
authors: Research Unit, and.
authors: Mireya
authors: M
authors: León
authors: Basic Medical Sciences Department, TEC-ABC School of Medicine, Tecnológico de Monterrey, Mexico 05300; and.
authors: Estibalitz
authors: E
authors: Laresgoiti-Servitje
authors: School of Medicine, South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Edinburg, Texas 78539.
authors: Ravindranath
authors: R
authors: Duggirala
authors: Department of Human Genetics, Hospital General de México Eduardo Liceaga-Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico.
authors: Teresa
authors: T
authors: Macías
authors: Department of Human Genetics, Hospital General de México Eduardo Liceaga-Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico.
authors: Sergio
authors: S
authors: Cuevas
authors: Department of Surgery, Hospital General de México Eduardo Liceaga, 06726 Mexico City, Mexico.
authors: Abel
authors: A
authors: Jalife
authors: Department of Human Genetics, Hospital General de México Eduardo Liceaga-Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico.
authors: Miguel
authors: M
authors: Fonseca-Sánchez
authors: Research Unit, and.
authors: Fabiola
authors: F
authors: Serratos
authors: School of Medicine, South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Edinburg, Texas 78539.
authors: Juan Carlos
authors: JC
authors: López-Alvarenga
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000032:analysis; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002648:Child; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D044243:Linoleic Acids, Conjugated / Q000627:therapeutic use*; D008055:Lipids / Q000032:analysis; D008297:Male; D024821:Metabolic Syndrome / Q000517:prevention & control*; D008687:Metformin / Q000627:therapeutic use*; D009765:Obesity / Q000150:complications / Q000188:drug therapy*; D011379:Prognosis
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D044243:Linoleic Acids, Conjugated; D008055:Lipids; D008687:Metformin