Metformin treatment to reduce central adiposity after prenatal growth restraint: a placebo‐controlled pilot study in prepubertal children. Issue 7 (20th October 2014)

• Record Type: Journal Article
• Authors: Díaz, Marta; Bassols, Judit; López‐Bermejo, Abel; de Zegher, Francis; Ibáñez, Lourdes
• Is Part Of: Pediatric diabetes. Volume 16:Issue 7(2015:Nov.)
• Page Start: 538
• Page End: 545
• Publication Date: 2014-10-20
• Subjects: Diabetes in children -- Periodicals; 616.462
• DOI: 10.1111/pedi.12220
• Languages: English
• ISSNs: 1399-543X

Abstract

<abstract abstract-type="main" id="pedi12220-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="pedi12220-sec-0001" sec-type="section"> <title>Background</title> <p id="pedi12220-para-0001">Children born small‐for‐gestational‐age (SGA) who experience rapid postnatal catch‐up in weight are at risk for central adiposity and hyperinsulinemia.</p> </sec> <sec id="pedi12220-sec-0002" sec-type="section"> <title>Objectives</title> <p id="pedi12220-para-0002">To study the effects of prepubertal metformin intervention over 24 months on the body composition and endocrine‐metabolic profile of catch‐up SGA children.</p> </sec> <sec id="pedi12220-sec-0003" sec-type="section"> <title>Methods</title> <p id="pedi12220-para-0003">Double‐blind, placebo‐controlled, pilot study including 23 post‐catch‐up non‐obese prepubertal SGA children [age, 7.7 yr; body mass index standard deviation score (BMI SDS) >50th and <97th centile for age] with increased visceral fat [by magnetic resonance imaging (MRI) and insulin‐like growth factor‐I (IGF‐I) both p > 75th for age]. Patients were randomized to receive either placebo or metformin (425 mg/d) for 24 months. Clinical, biochemical [IGF‐I, glucose, insulin, lipids, androgens, sex‐hormone‐binding globulin (SHBG) and high‐molecular‐weight (HMW)‐adiponectin] and imaging [body composition (absorptiometry and MRI; carotid intima‐media thickness (ultrasonography)] variables were assessed at baseline, and at 6, 12, and 24 months.</p> </sec> <sec id="pedi12220-sec-0004" sec-type="section"> <title>Results</title> <p id="pedi12220-para-0004">After 24 months, metformin‐treated children were leaner, had higher SHBG levels, and less total and abdominal fat than placebo‐treated children (all p ≤ 0.05). Longitudinal analyses showed that metformin had a significant effect on anthropometric (weight, BMI, and waist) and biochemical variables [glucose, homeostasis model assessment‐insulin resistance (HOMA‐IR), and triglycerides] (all p ≤ 0.05); and in total and abdominal fat (p = 0.01 and p = 0.02).</p> </sec> <sec id="pedi12220-sec-0005" sec-type="section"> <title>Conclusions</title> <p id="pedi12220-para-0005">Prepubertal intervention with metformin reduces central adiposity and improves insulin sensitivity in non‐obese catch‐up SGA children.</p> </sec> </abstract>