ESPE Abstracts (2016) 86 P-P1-471

Improved Clinical and Laboratory Changes after 12 Months of Use of Metformin in Obese Insulin Resistant Children and Adolescents

Louise Cominatoa, Ruth Rochaa, Ludmilla Renie Oliveira Rachidb, Nathalia Filgueiras Vilaça Duarteb, Natália Cinquini Freitas Francob, Marina Ybarraa, Leandra Steinmetza & Durval Damianic

aAssistant of Pediatric Endocrinology Unit of the Children’s Institute, HCFMUSP, Sao Paulo, Brazil; bPediatric Endocrinologist Fellow, Sao Paulo, Brazil; cDivision Chief of Pediatric Endocrinology Unit of the Children’s Institute, HCFMUSP, Sao Paulo, Brazil

Background: Childhood obesity is one of the most prevalent and challenging health care concerns. In this context, insulin resistance (IR) is an important disorder with strong association with metabolic (type 2 diabetes, hypercholesterolemia) and cardiovascular (hypertension, atherosclerosis) outcomes. Clinical trials have been showing Metformin as an effective drug on reducing the IR and BMI. However, there is little data on use of metformin in children.

Objective and hypotheses: The aim of this study is to evaluate our experience on use of metformin in obese children and adolescents with IR, and determine the benefits in weight loss after 12 months of treatment. Other clinical and biochemical variables were described.

Method: Retrospective study of 50 children and adolescents followed in the Pediatric Endocrinology Clinic ICR-FMUSP, due to obesity and IR, at baseline and after a year of use of metformin. Exclusion criteria: T2DM, Neurological disorders with or without mental impairments and use of other weight related medications. Clinical (age, gender, weight, height, waist circumference, BMI, pubertal stage) and biochemical (fasting glucose, insulin, lipid profile) data were analyzed. IR was measured by HOMA-IR.

Results: Mean age 12.4±2.2 (8–17 years), without gender predominance. At baseline and 12 months after metformin’s introduction, statistical analyses of the studied variables were respectively: HOMA-IR: 4.7±2.5, 3.56±1.8 (P=0.005); fasting insulin 23±9.5, 17.3±9.1 (P<0.001); BMI score Z 3.2±0.67, 2.9±0.58 (P<0.001). There was a statistical improvement in fasting glycemia (P=0.002) and cholesterol (P=0.041). There were no significant differences in outcomes between others variables.

Conclusion: Metformin increased insulin sensitivity, and provided a statistically significant, but very modest reduction in BMI. This poor alteration in BMI makes our results arguable. Further researches are needed to prove if there is a substantial clinical benefit on using metformin in children and adolescents.