BOSTON — Metformin was associated with weight loss that persisted at 12 months in obese adolescents at risk for diabetes, Dr. Dorit Koren said at the annual meeting of the Endocrine Society.
On the basis of the results of this small retrospective study, metformin should be submitted to further testing as a tool in the prevention of diabetes in high-risk, obese teens, she said. In previous studies of similar patients, metformin has been associated with short-term weight loss, as well as improvements in glucose levels, lipid abnormalities, and hyperandrogenism.
To determine whether the weight losses persisted at 12 months, Dr. Koren and colleagues at St. Christopher's Hospital for Children, Philadelphia, reviewed the charts of 26 nondiabetic adolescents seen in that institution's endocrine clinic. Their mean age was 14 years, and their body mass indexes were above the 95th percentile.
Metformin, 1,000 mg/day, was given to 14 of the teens because they had abnormal cholesterol values (HDL less than 40 mg/dL, triglycerides greater than 110 mg/dL) or fasting insulin levels greater than 20 μU/mL, or because of menstrual irregularities associated with polycystic ovary syndrome. At baseline and at 6 and 12 months, all of the patients underwent height and weight evaluations to calculate BMI and blood tests to measure cholesterol, blood sugar, and insulin levels.
The BMI scores of the treated group declined from 2.50 times above the average measures for age and sex to 2.35 times above average, Dr. Koren said in a poster presentation. BMI did not significantly change in the untreated group. For the treated versus the untreated groups, changes in BMI baseline score were significantly different at 6 months and still within the range of significance at 12 months. Cholesterol measures were initially better in the metformin group, but the differences between the two groups were no longer statistically significant at 12 months.
Metformin might be viewed as a complement to dietary and exercise changes in obese adolescents, she said. Its long-term safety and efficacy in nondiabetic adolescents has yet to be confirmed. Dr. Koren reported no conflicts of interest.