Context: Insulin resistance precedes metabolic syndrome abnormalities and may promote cardiovascular disease and type 2 diabetes in children with obesity. Results of lifestyle modification programs have been discouraging, and the use of adjuvant strategies has been necessary.
Objective: This study aimed to evaluate the effects of metformin and conjugated linoleic acid (CLA) on insulin sensitivity, measured via euglycemic-hyperinsulinemic clamp technique and insulin pathway expression molecules in muscle biopsies of children with obesity.
Design: A randomized, double-blinded, placebo-controlled clinical trial was conducted.
Setting: Children with obesity were randomly assigned to receive metformin, CLA, or placebo.
Results: Intervention had a positive effect in all groups. For insulin sensitivity Rd value (mg/kg/min), there was a statistically significant difference between the CLA vs placebo (6.53 ± 2.54 vs 5.05 ± 1.46, P = 0.035). Insulinemia and homeostatic model assessment of insulin resistance significantly improved in the CLA group (P = 0.045). After analysis of covariance was performed and the influence of body mass index, age, Tanner stage, prescribed diet, and fitness achievement was controlled, a clinically relevant effect size on insulin sensitivity remained evident in the CLA group (37%) and exceeded lifestyle program benefits. Moreover, upregulated expression of the insulin receptor substrate 2 was evident in muscle biopsies of the CLA group.
Conclusions: Improvement of insulin sensitivity, measured via euglycemic-hyperinsulinemic clamp and IRS2 upregulation, favored patients treated with CLA.
Trial registration: ClinicalTrials.gov NCT02063802.
Garibay-Nieto, N., Queipo-García, G., Alvarez, F., Bustos, M., Villanueva, E., Ramírez, F., León, M., Laresgoiti-Servitje, E., Duggirala, R., Macías, T., Cuevas, S., Jalife, A., Fonseca-Sánchez, M., Serratos, F., & López-Alvarenga, J. C. (2017). Effects of Conjugated Linoleic Acid and Metformin on Insulin Sensitivity in Obese Children: Randomized Clinical Trial. The Journal of clinical endocrinology and metabolism, 102(1), 132–140. https://doi.org/10.1210/jc.2016-2701
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J Clin Endocrinol Metab
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