The effects of metformin on insulin resistance in overweight or obese children and adolescents: A PRISMA-compliant systematic review and meta-analysis of randomized controlled trials

Sun, Juan; Wang, Ya; Zhang, Xiaoyi; He, Hong

doi:10.1097/md.0000000000014249

Cited by 23 publications

(24 citation statements)

References 24 publications

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“…In addition, we selected a final cohort with several follow-up clinic visits that included weight and BMI measurements over a 24-month period, so this may have resulted in selection of highly motivated patients desiring weight loss. Unlike other trials and meta-analysis reviews (24,25,29,33), this study demonstrated minimal effect of metformin on cardiometabolic outcomes such as lipid and glycemic profiles. It is possible that incomplete laboratory data may have provided insufficient power to detect a more significant difference in cardiometabolic outcomes.…”

Section: Discussioncontrasting

confidence: 60%

Metformin for pediatric obesity and insulin resistance: a retrospective study within an integrated health care system

Concepcion

Tucker

Huang

2021

Obesity

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Pediatric obesity is a significant public health problem in the United States, with 13 million children and adolescents aged 2 to 19 years (18.5%) diagnosed with obesity (1). The prevalence of obesity is higher among Hispanic youth (25.8%) and non-Hispanic Black youth (22%) than among non-Hispanic White youth (14.1%) and non-Hispanic Asian youth (11%). In recent years, the prevalence of pediatric obesity has increased slowly, albeit significantly, with 20.6% of adolescents 12 to 19 years old diagnosed with obesity (1), and nearly 6% of children and adolescents classified as having severe obesity, which is defined as having BMI (calculated as weight in kilograms divided by height in meters squared) 20% above the 95th percentile or ≥35 (2).Pediatric obesity is associated with many comorbid conditions that involve almost every organ system, including hyperglycemia, hyperandrogenism, asthma, obstructive sleep apnea, nonalcoholic fatty liver disease, cholelithiasis, pancreatitis, renal disease, orthopedic problems, and mood disorders (3). Furthermore, type 2 diabetes mellitus (T2DM), hypertension, and hyperlipidemia are significant cardiovascular risk factors. The incidence of T2DM among adolescents with overweight has increased dramatically over the past decade. In a 2017 report, overall unadjusted rates of T2DM increased by 7.1% annually over a 10-year period (4), and an estimated one in three children born after the year 2000 will develop T2DM in their lifetime. Childhood obesity frequently persists into adulthood and increases cardiovascular risk factors such as hypertension and

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Section: Discussioncontrasting

confidence: 60%

Metformin for pediatric obesity and insulin resistance: a retrospective study within an integrated health care system

Concepcion

Tucker

Huang

2021

Obesity

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“…Metformin inhibits hepatic gluconeogenesis by activating the phosphorylation of AMPK in hepatocytes, 3 and reduces BG by enhancing the biological effects of glucagon-raising peptide I (GLP-1) 16 and increasing insulin sensitivity. 5 AMPK signal transduction pathway in glomeruli and tubules was inhibited in high glucose environment, while PI3K/Akt signal transduction pathway was activated, leading to the activation of mTOR. Activation of mTOR can induce basement membrane thickening and increase the synthesis of proteins related to mesangial matrix accumulation, and increase the proliferation of renal fibroblasts.…”

Section: Discussionmentioning

confidence: 99%

“…insulin sensitivity of peripheral tissues. 5 Recent studies also found that metformin could inhibit endoplasmic reticulum stress, epithelial-mesenchymal transition and oxidative stress, promote the expression of hypoxia-inducible factor (HIF) and autophagy in renal tissue of DN patients, and protect renal tissue. 6,7 Autophagy is a highly conserved protective mechanism in eukaryotic cells.…”

mentioning

confidence: 99%

Metformin alleviates renal injury in diabetic rats by inducing Sirt1/FoxO1 autophagic signal axis

Liu

et al. 2020

Clin Exp Pharma Physio

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Diabetic nephropathy (DN) is the major microvascular complication of diabetes mellitus and the most important cause of end‐stage renal disease worldwide. Metformin is the preferred oral hypoglycaemic drug for type 2 diabetes mellitus (T2DM). Recent studies have shown that besides lowering blood glucose, metformin also has protective effects on renal function, but its mechanism is not clear. In this study, we established a diabetic rat model by high‐fat feeding combined with intraperitoneal injection of streptozotocin. Their changes of renal function, oxidative stress, histopathology and structure, and autophagy were observed after 8 weeks of metformin treatment at different dose. Sirt1 inhibitor EX527 and metformin were used to observe whether the protective effect of metformin on DN kidney was achieved through the Sirt1/FoxO1 autophagic signalling pathway. The results showed that metformin could protect renal function by up‐regulating autophagy level, alleviating oxidative stress level of renal tissue and pathological and structural changes of glomeruli, and inhibiting the expression of extracellular matrix. Sirt1 inhibitor could block the protective effect of metformin on kidney of diabetic rats, suggesting that metformin could alleviate kidney injury in diabetic rats by inducing Sirt1/FoxO1 autophagy signal axis. So metformin could alleviate renal injury in diabetic rats, which may be achieved by regulating Sirt1/FoxO1 autophagic signalling pathway and inducing renal autophagy.

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“…Furthermore, it was observed that some patients abandoned the different studies due to lack of interest, loss of contact, or refusal to participate [48]. Another study evaluating the efficacy, tolerability and safety of metformin in adolescents with obesity and insulin resistance, found that, during the first months of treatment, there was a decrease in BMI and HOMA, however, it was not possible to observe the same long-term result secondary to factors such as low adherence to treatment and the possible low doses indicated [49].…”

Section: Discussionmentioning

confidence: 99%

Proof on Concept on the Consumption of a Beverage with Ancestral Mexican Corn and Bean Flour and its Cardiometabolic Effects on Adolescents with Obesity

Gutiérrez-Salmeán¹

2021

AJBSR

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The effects of metformin on insulin resistance in overweight or obese children and adolescents: A PRISMA-compliant systematic review and meta-analysis of randomized controlled trials

Abstract: Supplemental Digital Content is available in the text

Cited by 23 publications

References 24 publications

Metformin for pediatric obesity and insulin resistance: a retrospective study within an integrated health care system

Metformin for pediatric obesity and insulin resistance: a retrospective study within an integrated health care system

Metformin alleviates renal injury in diabetic rats by inducing Sirt1/FoxO1 autophagic signal axis

Proof on Concept on the Consumption of a Beverage with Ancestral Mexican Corn and Bean Flour and its Cardiometabolic Effects on Adolescents with Obesity

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