Adipokines in Obese Adolescents With Insulin Resistance
- Registration Number
- NCT01410604
- Lead Sponsor
- Hospital Regional de Alta Especialidad del Bajio
- Brief Summary
The purpose of this study is to compare serum concentrations of inflammatory cytokines, interleukin 6 (IL-6), High-sensitivity C-reactive protein (hs-CRP), adiponectin, and tumour necrosis factor alpha (TNFα), before and after three months treatment with metformin in obese adolescents with insulin resistance (IR).
- Detailed Description
The increased prevalence of obesity in pediatric patients is a public health problem particularly because of the difficulties involved with changing lifestyles. Current studies of obese children and adolescents show increased insulin resistance (IR) and chronic inflammatory states. These conditions increase the risk of disability and/or premature death.
The current treatment schemes for obese children are conservative and are focused on changing their lifestyles (exercise and dietary plans). However, metabolic conditions, such as IR, dyslipidemia, and inflammatory processes, are perpetuated.
Metformin is a biguanide that is used for adolescents with diabetes mellitus and polycystic ovarian syndrome. Several clinical trials with metformin for obese pediatric patients have observed decreases in IR, decreases in weight, and improvements in lipid metabolism.
Adipose tissue is not only an energy repository, but also plays an immunological role by the secretion of cytokines. Both overweight adults and adolescents show decreases in adiponectin levels and increases in tumor necrosis factor alpha (TNFα) and interleukin 6 (IL-6). IL-6 can stimulate the production of high-sensitivity C-reactive protein (hs-CRP), which is considered to be a risk marker for the development of cardiovascular disease.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 31
- Obesity defined as Body Mass Index (BMI) ≥ percentile 95
- Tanner stage ≥ 2
- Insulin resistance defined as Basal insulin > 15 µU/mL or Homeostasis Model Assessment index (HOMA) > 4.5
- Patients' parents signed written consents when they and their adolescent children agreed to enroll
- Glucose intolerance
- Diabetes mellitus (type 1 or 2)
- Anemia (Hb < 10 g/dL)
- Plasma creatinine > 1.4 mg/dL
- Abnormal hepatic function
- Any associated Disease (Pulmonary, Infection, Autoimmune Disease)
- History of lactic acidosis
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Metformin Metformin Tablet of 500 mg metformin, oral every 12 hours (total metformin dose of 1 g/day) for 3 months. Placebo Placebo Tablet of 500 mg oral placebo every 12 hours for 3 months.
- Primary Outcome Measures
Name Time Method Adiponectin baseline and 3 months Change from baseline in Adiponectin after 3 months of treatment.
High-sensitivity C-reactive Protein baseline and 3 months Change from baseline in High-sensitivity C-reactive protein after 3 months of treatment.
Interleukin 6 baseline and 3 months Change from baseline in Interleukin 6 after 3 months of treatment.
Tumour Necrosis Factor Alpha baseline and 3 months Change from baseline in Tumour necrosis factor alpha after 3 months of treatment.
- Secondary Outcome Measures
Name Time Method Fasting Plasma Glucose baseline and 3 months Change from baseline in Fasting plasma glucose after 3 months of treatment.
Fasting Insulin baseline and 3 months Change from baseline in Fasting insulin after 3 months of treatment.
Body Mass Index baseline and 3 months Change from baseline in Body Mass Index after 3 months of treatment.
Waist Circumference baseline and 3 months Change from baseline in Waist circumference after 3 months of treatment.
Trial Locations
- Locations (2)
Hospital Regional de Alta Especialidad del Bajío
🇲🇽León, Guanajuato, Mexico
Hospital Infantil de México Federico Gómez
🇲🇽México, Distrito Federal, Mexico