Metformin Therapy Reduces Obesity Indices in Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Abstract

Purpose: Few studies have summarized findings for the effect of metformin on obesity indices. Therefore, we aimed to conduct a systematic review and meta-analysis on the effect of metformin on obesity indices among children and adolescents.Methods: Relevant articles published up to September 2018 were searched in SCOPUS, Medline, and Google Scholar using appropriate keywords. All clinical trials that examined the effect of metformin on obesity indices in children and adolescents were included.Results: Overall, 38 studies, including 2199 participants (39.75% male and 60.25% female), were included. The pooled results indicated that metformin significantly reduced BMI [weighted mean difference (WMD): -1.07 kg/m 2 ; 95% confidence interval (CI): -1.43 to -0.72]. Same findings were found for waist circumference (WC) (WMD: -1.93 cm; 95% CI: -2.69 to -1.16). Metformin also reduced body weight in all participants (WMD: -2.51 kg; 95% CI: -3.14 to -1.89). Moreover, it reduced body fat mass in patients with overweight or obesity (WMD: -1.90%; 95% CI: -3.25 to -0.56) and chronic diseases (WMD: -1.41%; 95% CI: -2.23 to -0.58), but not among those with growth problems. Metformin therapy did not affect lean body mass (LBM) in patients with overweight or obesity and growth problems; however, it reduced LBM in patients with chronic diseases (WMD: -1.49 kg; 95% CI: -2.69 to -0.30).Conclusions: We found a significant reduction in BMI, body weight, WC, and fat mass following administration with metformin. However, the effect of metformin on LBM was not significant. Further studies are required to confirm these findings.

Metformin intervention ameliorates AS in ApoE-/- mice through restoring gut dysbiosis and anti-inflammation

“…In this study, a significant reduction of BWs in AS with MET intervention demonstrated that oral MET administration may regulate energy metabolism in AS. Sadeghi et al have shown that MET therapy reduces BMI in adolescents and adults [40]. In addition, no significant change in food intake among diverse groups indicated that the effectiveness of MET intervention was not attributed to the differential food intake.…”

“…A study showed a significant decrease of Akkermansia in atherosclerotic ApoE -/mice [58]. MET has been proven to improve metabolic profiles in aged obese mice partially through modulating gut Akkermansia [40]. Transplantation of extracellular vesicles of Akkermansia muciniphila improved the BW and lipid profiles of the mice [59].…”

Is metformin effective for reducing weight in obese or overweight adolescents?

“…A large systematic review and metaanalysis (38 RCTs; n = 2199) published in 2020 evaluated metformin therapy in children and adolescents (including those with metabolic disease, growth problems, and psychological disorders in addition to obesity and overweight). 1 Over an average of 6 months, metformin use modestly reduced BMI (weighted mean difference [WMD] = -1.07 kg/m 2 ; 95% CI, -1.43 to -0.72 kg/m 2 ) and body weight (WMD = -2.51 kg; 95% CI, -3.14 to -1.89 kg) for all participants. 1 However, the authors also performed a meta-analysis of trials involving obese or overweight youth without other comorbidities.…”

“…1 Over an average of 6 months, metformin use modestly reduced BMI (weighted mean difference [WMD] = -1.07 kg/m 2 ; 95% CI, -1.43 to -0.72 kg/m 2 ) and body weight (WMD = -2.51 kg; 95% CI, -3.14 to -1.89 kg) for all participants. 1 However, the authors also performed a meta-analysis of trials involving obese or overweight youth without other comorbidities. Participants in these trials ranged in age from 7 to 17 years (mean not supplied; most trials, 12-15 years), had a BMI greater than the 95th percentile for age, and took doses of metformin ranging from 1500 to 3000 mg (most trials, 1500-2000 mg/d for 24 weeks).…”

Critério da Associação Brasileira de Nutrologia para diagnóstico e tratamento da síndrome metabólica em crianças e adolescentes

“…Possui propriedade de causar perda de peso, mas associada à mudança do estilo de vida. 61 A metformina está associada também com a melhora do perfil lipídico. Pode apresentar manifestações gastrointestinais importantes como efeitos colaterais, mas as formas de liberação prolongada reduziram drasticamente estes sintomas.…”