Startseite Metformin treatment improves weight and dyslipidemia in children with metabolic syndrome
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

Metformin treatment improves weight and dyslipidemia in children with metabolic syndrome

  • Diane Q. Luong , Robert Oster und Ambika P. Ashraf EMAIL logo
Veröffentlicht/Copyright: 11. September 2014
Journal of Pediatric Endocrinology and Metabolism
Aus der Zeitschrift Journal of Pediatric Endocrinology and Metabolism Band 28 Heft 5-6

Abstract

Background: To determine the effects of metformin therapy in children with metabolic syndrome (MS).

Methods: A retrospective electronic chart review in children aged 8–18 years, from 2000 to 2012 with a diagnosis code for MS (ICD 277.7) that met the modified NCEP ATPIII criteria for MS.

Results: There were a total of 217 subjects, 150 in the non-metformin [untreated group (UTG)] and 67 in the metformin treated group (MTG). At baseline, the MTG had a body mass index (BMI) similar to UTG, but had higher total cholesterol, low-density lipoprotein cholesterol (LDL-C), and non-high density lipoprotein cholesterol (non-HDL-C). At the end of 1 year, the MTG (n=28) had reduced weight percentile (99.4±0.7 vs. 98.9±1.7, p=0.03), BMI percentile (99.2±0.5 vs. 98.8±1.1, p=0.012), total cholesterol (194.9±45.8 vs. 177.9±32.5 mg/dL, p=0.04), LDL-C (128.3±44.7 vs. 113.8±36.0 mg/dL, p=0.04), and non-HDL-C (154.6±45.5 vs. 136.4±35.2 mg/dL, p=0.03) compared to their baseline. The UTG (n=56) did not have any significant change in those parameters.

Conclusions: Metformin treatment results in significant improvement in BMI, total cholesterol, LDL-C, and non-HDL-C in children with MS.

Keywords: cardiovascular risk; dyslipidemia; metabolic syndrome (MS); metformin
Corresponding author: Ambika P. Ashraf, MD, Department of Pediatrics/Division of Pediatric Endocrinology and Metabolism, Children’s of Alabama, UAB, CPP 230, 1601 Fourth Ave S., Birmingham, AL 35233, USA, Phone: +205 638 9107, Fax: +205 638 9821, E-mail:

References

1. Grundy SM. Metabolic syndrome pandemic. Arterioscler Thromb Vasc Biol 2008;28:629–36.10.1161/ATVBAHA.107.151092Suche in Google Scholar PubMed

2. Weiss R, Bremer AA, Lustig RH. What is metabolic syndrome, and why are children getting it? Ann NY Acad Sci 2013;1281:123–40.10.1111/nyas.12030Suche in Google Scholar PubMed PubMed Central

3. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735–52.10.1161/CIRCULATIONAHA.105.169404Suche in Google Scholar PubMed

4. Sumner AE. The relationship of body fat to metabolic disease: influence of sex and ethnicity. Gend Med 2008;5:361–71.10.1016/j.genm.2008.11.003Suche in Google Scholar PubMed PubMed Central

5. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998;101:518–25.10.1542/peds.101.S2.518Suche in Google Scholar

6. Reinehr T, de Sousa G, Toschke AM, Andler W. Comparison of metabolic syndrome prevalence using eight different definitions: a critical approach. Arch Dis Child 2007;92:1067–72.10.1136/adc.2006.104588Suche in Google Scholar PubMed PubMed Central

7. Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 2004;350:2362–74.10.1056/NEJMoa031049Suche in Google Scholar PubMed

8. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation 2002;106:3143–421.10.1161/circ.106.25.3143Suche in Google Scholar

9. Invitti C, Maffeis C, Gilardini L, Pontiggia B, Mazzilli G, et al. Metabolic syndrome in obese Caucasian children: prevalence using WHO-derived criteria and association with nontraditional cardiovascular risk factors. Int J Obes (Lond) 2006;30:627–33.10.1038/sj.ijo.0803151Suche in Google Scholar PubMed

10. Saffari F, Jalilolghadr S, Esmailzadehha N, Azinfar P. Metabolic syndrome in a sample of the 6- to 16-year-old overweight or obese pediatric population: a comparison of two definitions. Ther Clin Risk Manag 2012;8:55–63.10.2147/TCRM.S26673Suche in Google Scholar PubMed PubMed Central

11. Mahmood K, Naeem M, Rahimnajjad NA. Metformin: the hidden chronicles of a magic drug. Eur J Intern Med 2013;24:20–6.10.1016/j.ejim.2012.10.011Suche in Google Scholar PubMed

12. Hardie DG. Metformin-acting through cyclic AMP as well as AMP? Cell Metab 2013;17:313–4.10.1016/j.cmet.2013.02.011Suche in Google Scholar PubMed

13. Miller RA, Chu Q, Xie J, Foretz M, Viollet B, et al. Biguanides suppress hepatic glucagon signalling by decreasing production of cyclic AMP. Nature 2013;494:256–60.10.1038/nature11808Suche in Google Scholar PubMed PubMed Central

14. Durnin JV, Womersley J. Body fat assessed from total body density and its estimation from skinfold thickness: measurements on 481 men and women aged from 16 to 72 years. Br J Nutr 1974;32:77–97.10.1079/BJN19740060Suche in Google Scholar PubMed

15. U.S. Department of health and Human Services, N.I.O.H., National Heart, Lung, and Blood Institute. Originally printed September 1996 (96-3790). Revised May 2005. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents, 2005:1–48.Suche in Google Scholar

16. Update on the 1987 Task Force Report on High Blood Pressure in Children and Adolescents: a working group report from the National High Blood Pressure Education Program. National High Blood Pressure Education Program Working Group on Hypertension Control in Children and Adolescents. Pediatrics 1996;98:649–58.10.1542/peds.98.4.649Suche in Google Scholar

17. Love-Osborne KA, Nadeau KJ, Sheeder J, Fenton LZ, Zeitler P. Presence of the metabolic syndrome in obese adolescents predicts impaired glucose tolerance and nonalcoholic fatty liver disease. J Adolesc Health 2008;42:543–8.10.1016/j.jadohealth.2007.11.136Suche in Google Scholar PubMed PubMed Central

18. Lustig R, Weiss R. Disorders of energy balance. Pediatric endocrinology, 3rd ed, Elsevier, 2008:788–838.10.1016/B978-141604090-3.50024-7Suche in Google Scholar

19. American Diabetes Association. Standards of medical care in diabetes – 2008. Diabetes Care 2008;31:S12–54.10.2337/dc08-S012Suche in Google Scholar PubMed

20. Weiss R, Taksali SE, Tamborlane WV, Burgert TS, Savoye M, et al. Predictors of changes in glucose tolerance status in obese youth. Diab Care 2005;28:902–9.10.2337/diacare.28.4.902Suche in Google Scholar PubMed

21. Hosker JP, Matthews DR, Rudenski AS, Burnett MA, Darling P, et al. Continuous infusion of glucose with model assessment: measurement of insulin resistance and beta-cell function in man. Diabetologia 1985;28:401–11.10.1007/BF00280882Suche in Google Scholar PubMed

22. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.10.1007/BF00280883Suche in Google Scholar

23. Virani SS. Non-HDL cholesterol as a metric of good quality of care: opportunities and challenges. Tex Heart Inst J 2011;38:160–2.Suche in Google Scholar

24. Yanovski JA, Krakoff J, Salaita CG, McDuffie JR, Kozlosky M, et al. Effects of metformin on body weight and body composition in obese insulin-resistant children: a randomized clinical trial. Diabetes 2011;60:477–85.10.2337/db10-1185Suche in Google Scholar

25. Wilson DM, Abrams SH, Aye T, Lee PD, Lenders C, et al. Metformin extended release treatment of adolescent obesity: a 48-week randomized, double-blind, placebo-controlled trial with 48-week follow-up. Arch Pediatr Adolesc Med 2010;164:116–23.Suche in Google Scholar

26. Ibanez L, Valls C, Potau N, Marcos MV, de Zegher F. Sensitization to insulin in adolescent girls to normalize hirsutism, hyperandrogenism, oligomenorrhea, dyslipidemia, and hyperinsulinism after precocious pubarche. J Clin Endocrinol Metab 2000;85:3526–30.10.1210/jc.85.10.3526Suche in Google Scholar

27. Fullerton MD, Galic S, Marcinko K, Sikkema S, Pulinilkunnil T, et al. Single phosphorylation sites in Acc1 and Acc2 regulate lipid homeostasis and the insulin-sensitizing effects of metformin. Nat Med 2013;19:1649–54.10.1038/nm.3372Suche in Google Scholar

28. Weiss R, Dufour S, Taksali SE, Tamborlane WV, Petersen KF, et al. Prediabetes in obese youth: a syndrome of impaired glucose tolerance, severe insulin resistance, and altered myocellular and abdominal fat partitioning. Lancet 2003;362:951–7.10.1016/S0140-6736(03)14364-4Suche in Google Scholar

29. Srinivasan SR, Myers L, Berenson GS. Distribution and correlates of non-high-density lipoprotein cholesterol in children: the Bogalusa Heart Study. Pediatrics 2002;110:e29.10.1542/peds.110.3.e29Suche in Google Scholar PubMed

30. Srinivasan SR, Frerichs RR, Webber LS, Berenson GS. Serum lipoprotein profile in children from a biracial community: the Bogalusa Heart Study. Circulation 1976;54:309–18.10.1161/01.CIR.54.2.309Suche in Google Scholar PubMed

31. Berenson GS, Srinivasan SR, Cresanta JL, Foster TA, Webber LS. Dynamic changes of serum lipoproteins in children during adolescence and sexual maturation. Am J Epidemiol 1981;113:157–70.10.1093/oxfordjournals.aje.a113080Suche in Google Scholar PubMed

32. Morrison JA, deGroot I, Edwards BK, Kelly KA, Mellies MJ, et al. Lipids and lipoproteins in 927 schoolchildren, ages 6 to 17 years. Pediatrics 1978;62:990–5.10.1542/peds.62.6.990Suche in Google Scholar

33. Srinivasan SR, Dahlen GH, Jarpa RA, Webber LS, Berenson GS. Racial (black-white) differences in serum lipoprotein (a) distribution and its relation to parental myocardial infarction in children. Bogalusa Heart Study. Circulation 1991;84:160–7.10.1161/01.CIR.84.1.160Suche in Google Scholar PubMed

34. Hickman TB, Briefel RR, Carroll MD, Rifkind BM, Cleeman JI, et al. Distributions and trends of serum lipid levels among United States children and adolescents ages 4–19 years: data from the Third National Health and Nutrition Examination Survey. Prev Med 1998;27:879–90.10.1006/pmed.1998.0376Suche in Google Scholar PubMed

Received: 2014-5-16
Accepted: 2014-8-14
Published Online: 2014-9-11
Published in Print: 2015-5-1

©2015 by De Gruyter

Artikel in diesem Heft

  1. Frontmatter
  2. Highlight: Obesity
  3. Childhood obesity at the crossroads
  4. Obesogenic environments: environmental approaches to obesity prevention
  5. Childhood obesity and eating behaviour
  6. Hypothalamic obesity in children: pathophysiology to clinical management
  7. The reliability of body mass index in the diagnosis of obesity and metabolic risk in children
  8. Determining abdominal obesity cut-offs and relevant risk factors for anthropometric indices in Turkish children and adolescents
  9. The effect of body mass index on blood pressure varies by race among obese children
  10. Insulin secretion response during oral glucose tolerance test is related to low cardiorespiratory fitness in obese adolescents
  11. Is there a relationship between cardiovascular risk factors and dehydroepiandrosterone sulfate levels in childhood obesity?
  12. The effect of lifestyle change and metformin therapy on serum arylesterase and paraoxonase activity in obese children
  13. Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study
  14. Associations between IGF-I, IGF-binding proteins and bone turnover markers in prepubertal obese children
  15. Osteocalcin is inversely associated with adiposity and leptin in adolescent boys
  16. Association between cardiovascular risk factors and carotid intima-media thickness in prepubertal Brazilian children
  17. Insulin resistance and cardiometabolic risk factors in obese children and adolescents: a hierarchical approach
  18. The role of apolipoprotein E polymorphism in improving dyslipidemia in obese adolescents following physical exercise and National Cholesterol Education Program Step II intervention
  19. Review article
  20. Is ultrasound useful in the diagnosis of adolescents with polycystic ovary syndrome?
  21. Original articles
  22. IGF-II expression and methylation in small for gestational age infants
  23. Early screening of FTO and MC4R variants in newborns of Greek origin
  24. Pitfalls in hormonal diagnosis of 17-beta hydroxysteroid dehydrogenase III deficiency
  25. The prevalence of vitamin D deficiency among schoolchildren: a cohort study from Xinxiang, China
  26. Management of testosterone therapy in adolescents and young men with hypogonadism: are we following adult clinical practice guidelines?
  27. Vitamin D status and its associations with components of metabolic syndrome in healthy children
  28. Metformin treatment improves weight and dyslipidemia in children with metabolic syndrome
  29. Patient reports
  30. Hypothyroidism caused by the combination of two heterozygous mutations: one in the TSH receptor gene the other in the DUOX2 gene
  31. Ovarian carcinoma in a 14-year-old with classical salt-wasting congenital adrenal hyperplasia and bilateral adrenalectomy
  32. An asymptomatic mother diagnosed with 3-methylcrotonyl-CoA carboxylase deficiency after newborn screening
  33. A new missense mutation in the BCKDHB gene causes the classic form of maple syrup urine disease (MSUD)
  34. Ovotesticular disorder of sex development with unusual karyotype: patient report
  35. First case report of medium-chain acyl-coenzyme A dehydrogenase deficiency in China
  36. Virilizing adrenal oncocytoma in a 9-year-old girl: rare neoplasm with an intriguing postoperative course
  37. Unexpected clinical features in a female patient with proopiomelanocortin (POMC) deficiency
  38. Sirolimus therapy in a patient with severe hyperinsulinaemic hypoglycaemia due to a compound heterozygous ABCC8 gene mutation
  39. Cross-reactivity of adrenal steroids with aldosterone may prevent the accurate diagnosis of congenital adrenal hyperplasia
  40. Hyperthyroidism hidden by congenital central hypoventilation syndrome
  41. The use of pamidronate for acute vitamin D intoxication, clinical experience with three cases
  42. Chondrocalcinosis related to familial hypomagnesemia with hypercalciuria and nephrocalcinosis
  43. Cushing syndrome related to leukemic infiltration of the central nervous system
  44. Hashimoto’s encephalopathy: a rare pediatric brain disease
  45. Short communication
  46. A novel ABCD1 gene mutation in a Chinese patient with X-linked adrenoleukodystrophy
https://doi.org/10.1515/jpem-2014-0201
Schlagwörter für diesen Artikel
cardiovascular risk; dyslipidemia; metabolic syndrome (MS); metformin

Artikel in diesem Heft

  1. Frontmatter
  2. Highlight: Obesity
  3. Childhood obesity at the crossroads
  4. Obesogenic environments: environmental approaches to obesity prevention
  5. Childhood obesity and eating behaviour
  6. Hypothalamic obesity in children: pathophysiology to clinical management
  7. The reliability of body mass index in the diagnosis of obesity and metabolic risk in children
  8. Determining abdominal obesity cut-offs and relevant risk factors for anthropometric indices in Turkish children and adolescents
  9. The effect of body mass index on blood pressure varies by race among obese children
  10. Insulin secretion response during oral glucose tolerance test is related to low cardiorespiratory fitness in obese adolescents
  11. Is there a relationship between cardiovascular risk factors and dehydroepiandrosterone sulfate levels in childhood obesity?
  12. The effect of lifestyle change and metformin therapy on serum arylesterase and paraoxonase activity in obese children
  13. Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study
  14. Associations between IGF-I, IGF-binding proteins and bone turnover markers in prepubertal obese children
  15. Osteocalcin is inversely associated with adiposity and leptin in adolescent boys
  16. Association between cardiovascular risk factors and carotid intima-media thickness in prepubertal Brazilian children
  17. Insulin resistance and cardiometabolic risk factors in obese children and adolescents: a hierarchical approach
  18. The role of apolipoprotein E polymorphism in improving dyslipidemia in obese adolescents following physical exercise and National Cholesterol Education Program Step II intervention
  19. Review article
  20. Is ultrasound useful in the diagnosis of adolescents with polycystic ovary syndrome?
  21. Original articles
  22. IGF-II expression and methylation in small for gestational age infants
  23. Early screening of FTO and MC4R variants in newborns of Greek origin
  24. Pitfalls in hormonal diagnosis of 17-beta hydroxysteroid dehydrogenase III deficiency
  25. The prevalence of vitamin D deficiency among schoolchildren: a cohort study from Xinxiang, China
  26. Management of testosterone therapy in adolescents and young men with hypogonadism: are we following adult clinical practice guidelines?
  27. Vitamin D status and its associations with components of metabolic syndrome in healthy children
  28. Metformin treatment improves weight and dyslipidemia in children with metabolic syndrome
  29. Patient reports
  30. Hypothyroidism caused by the combination of two heterozygous mutations: one in the TSH receptor gene the other in the DUOX2 gene
  31. Ovarian carcinoma in a 14-year-old with classical salt-wasting congenital adrenal hyperplasia and bilateral adrenalectomy
  32. An asymptomatic mother diagnosed with 3-methylcrotonyl-CoA carboxylase deficiency after newborn screening
  33. A new missense mutation in the BCKDHB gene causes the classic form of maple syrup urine disease (MSUD)
  34. Ovotesticular disorder of sex development with unusual karyotype: patient report
  35. First case report of medium-chain acyl-coenzyme A dehydrogenase deficiency in China
  36. Virilizing adrenal oncocytoma in a 9-year-old girl: rare neoplasm with an intriguing postoperative course
  37. Unexpected clinical features in a female patient with proopiomelanocortin (POMC) deficiency
  38. Sirolimus therapy in a patient with severe hyperinsulinaemic hypoglycaemia due to a compound heterozygous ABCC8 gene mutation
  39. Cross-reactivity of adrenal steroids with aldosterone may prevent the accurate diagnosis of congenital adrenal hyperplasia
  40. Hyperthyroidism hidden by congenital central hypoventilation syndrome
  41. The use of pamidronate for acute vitamin D intoxication, clinical experience with three cases
  42. Chondrocalcinosis related to familial hypomagnesemia with hypercalciuria and nephrocalcinosis
  43. Cushing syndrome related to leukemic infiltration of the central nervous system
  44. Hashimoto’s encephalopathy: a rare pediatric brain disease
  45. Short communication
  46. A novel ABCD1 gene mutation in a Chinese patient with X-linked adrenoleukodystrophy
Jetzt anmelden und 20% sparen
Institutioneller Zugang
Wie funktioniert Authentifizierung?
Haben Sie eine Idee, wie wir unsere Website verbessern können?
Bitte schreiben Sie uns.
© 2025 De Gruyter Brill
Heruntergeladen am 5.11.2025 von https://www.degruyterbrill.com/document/doi/10.1515/jpem-2014-0201/html?lang=de
Button zum nach oben scrollen