Effects of Metformin on Body Weight and Body Composition in Obese Insulin-Resistant Children
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OBJECTIVE: Metformin can decrease adiposity and ameliorate obesity-related comorbid conditions, including abnormalities in glucose homeostasis in adolescents, but there are few data evaluating the efficacy of metformin among younger children. Our objective was to determine whether metformin treatment causes weight loss and improves obesity-related comorbidities in obese children, who are insulin-resistant. RESEARCH DESIGN AND METHODS: This study was a randomized double-blind placebo-controlled trial consisting of 100 severely obese (mean BMI 34.6 ± 6.6 kg/m(2)) insulin-resistant children aged 6-12 years, randomized to 1,000 mg metformin (n = 53) or placebo (n = 47) twice daily for 6 months, followed by open-label metformin treatment for 6 months. All children and their parents participated in a monthly dietitian-administered weight-reduction program. RESULTS: Eighty-five percent completed the 6-month randomized phase. Children prescribed metformin had significantly greater decreases in BMI (difference -1.09 kg/m(2), CI -1.87 to -0.31, P = 0.006), body weight (difference -3.38 kg, CI -5.2 to -1.57, P < 0.001), BMI Z score (difference between metformin and placebo groups -0.07, CI -0.12 to -0.01, P = 0.02), and fat mass (difference -1.40 kg, CI -2.74 to -0.06, P = 0.04). Fasting plasma glucose (P = 0.007) and homeostasis model assessment (HOMA) insulin resistance index (P = 0.006) also improved more in metformin-treated children than in placebo-treated children. Gastrointestinal symptoms were significantly more prevalent in metformin-treated children, which limited maximal tolerated dosage in 17%. During the 6-month open-label phase, children treated previously with placebo decreased their BMI Z score; those treated continuously with metformin did not significantly change BMI Z score further. CONCLUSIONS: Metformin had modest but favorable effects on body weight, body composition, and glucose homeostasis in obese insulin-resistant children participating in a low-intensity weight-reduction program.
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Metformin-induced weight loss is almost exclusively confined to reductions in adipose mass with little change in lean tissue.
“This is because metformin-induced weight loss is almost exclusively confined to reductions in adipose mass (2,16,18) with little change in lean tissue.”
From Long-Term Safety, Tolerability, and Weight Loss Associated With Metformin in the Diabetes Prevention Program Outcomes Study (2012) · cites this paper as [16]
Metformin lowers glucose and reduces risk for diabetes in part through weight loss.
“Metformin lowers glucose and reduces risk for diabetes in part through weight loss (2,7,16,17).”
From Long-Term Safety, Tolerability, and Weight Loss Associated With Metformin in the Diabetes Prevention Program Outcomes Study (2012) · cites this paper as [16]
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- Authors
- Yanovski, J. A., Krakoff, J., Salaita, C. G., McDuffie, J. R., Kozlosky, M., Sebring, N. G., Reynolds, J. C., Brady, S. M., & Calis, K. A.
- Affiliations
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (US)
- National Institute of Diabetes and Digestive and Kidney Diseases (US)
- National Institutes of Health (US)
- Corresponding author
- Yanovski, Jack A.
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2011-01-21
- Volume
- 60
- Issue
- 2
- Pages
- 477-485
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- PMC
- PMC3028347
- OpenAlex
- W2110798021
- Cited by
- 193
- References
- 53
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 8 · 2023: 13 · 2022: 4 · 2021: 11 · 2020: 11 · 2019: 9 · 2018: 17 · 2017: 18 · 2016: 24 · 2015: 8 · 2014: 15 · 2013: 18 · 2012: 15
- FWCI
- 12.65
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (Z01HD000641)
- Topics
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Keywords
- metformin, childhood obesity, insulin resistance, weight loss, body composition, fat mass, glucose homeostasis, fasting blood glucose, HOMA-IR, slimming program, gastrointestinal adverse effects
- MeSH terms
- Body Composition, Body Weight, Child, Double-Blind Method, Female, Humans, Hypoglycemic Agents, Insulin Resistance, Male, Metformin, Obesity, Treatment Outcome
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