Efecto metabólico de la metformina en adolescentes obesas con riesgo de diabetes mellitus tipo 2

Abstract

Metabolic effect of metformin in obese adolescents at risk of diabetes mellitus type 2In adults, metformin promotes weight loss and prevents the development of type 2 diabetes mellitus (DM2). However, these effects have not been demonstrated in adolescents at risk for DM2. Objective: To analyze the anthropometric and metabolic impact of metformin in obese adolescents at risk for DM2. Patients and Methods: A double-blind, placebo-controlled study was conducted in 19 obese female adolescents at risk for DM2. A structured lifestyle intervention with nutritional and exercise education and motivational support was assessed over 3 month with an additional follow up period of 3 months. Subjects were randomized to 500 mg/ daily of extended release metformin or placebo. Anthropometric (weight, BMI, waist circumference, blood pressure) and metabolic profi les (glycemia, HOMA, lipid profi le, AST, ALT) were compared between both groups at the end of both periods. Results: Metformin treated group showed a signifi cant reduction in weight and body mass index (BMI) compared with placebo group. No improvement in the metabolic risk profi le was showed in any group. Conclusion: In this study, metformin therapy in combination with a lifestyle intervention helps to reduce weight and BMI in obese adolescent females at risk for DM2, compared to lifestyle and placebo intervention.

Pharmacological interventions for the management of children and adolescents living with obesity—An update of a Cochrane systematic review with meta‐analyses

“…Proportion female ranged from 28% 36 to 100%. 57 Most participants were White; the proportions of other race and ethnicity ranged from 0% 37 to 63%. 64 Mean BMI ranged from 26.2 58 to 41.7 kg/m 2 .…”

“…The update searches identified 1287 records, of which 14 new RCTs 30–43 (41 records) were included and combined with 21 RCTs 44–64 (33 records) from the Cochrane review, 12 making a total of 35 RCTs. Of the 35 included trials, two were identified from trial registry searches alone and are terminated trials (NCT02273804 and NCT03338296) 30,31 .…”

“…Five trials 39,40,43,47,61 were conducted in multiple countries. The length of intervention ranged from 12 weeks 57,58,60 to 2 years 32 . Five RCTs 39,43,58,60,62 reported data after a follow‐up period of no treatment.…”

“…One trial 35 did not report mean age but included a range of 6.8–15.3 years. Proportion female ranged from 28% 36 to 100% 57 . Most participants were White; the proportions of other race and ethnicity ranged from 0% 37 to 63% 64 .…”

“…À2.27 to À1.14], I 2 = 85%). Ten trials were excluded from BMI analysis, of which five 49,[56][57][58][59] were excluded from the BMI analysis in the Cochrane review due to methodological concerns, 12 two were terminated trials, 30,31 one 37 reported insufficient data, and two were classed as weight loss maintenance trials and data were reported separately. 33,41 Drug type explained approximately 44.46% of heterogeneity.…”