HealthDay News — In prepubertal, but not pubertal, children with obesity, metformin is associated with decreased BMI z score and improved inflammatory and cardiovascular-related obesity parameters, according to a study published online in Pediatrics.

Belén Pastor-Villaescusa, PhD, from the University of Granada in Spain, and colleagues conducted a randomized trial at 4 Spanish clinical hospitals involving 80 prepubertal and 80 pubertal children (aged 7-14 years) without diabetes who were obese. Participants received 1 gram/day of metformin or placebo for 6 months.

The researchers found that metformin correlated with a decrease in the BMI z score versus placebo in the prepubertal group (-0.8 and -0.6, respectively; P =.04). In prepubertal children there were significant increments in the quantitative insulin sensitivity check index with metformin versus placebo (0.010 and -0.007; P =.01) and in the adiponectin-leptin ratio (0.96 and 0.15; P =.01); declines were seen in interferon γ (-5.6 and 0; P =.02) and total plasminogen activator inhibitor-1 (-1.7 and 2.4; P =.04). There were no reports of serious adverse effects.

“Metformin decreased the BMI z score and improved inflammatory and cardiovascular-related obesity parameters in prepubertal children but not in pubertal children,” the authors write. “The differential response according to puberty might be related to the dose of metformin per kilogram of weight. Further investigations are necessary.”

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Pastor-Villaescusa B, Canete MD, Caballero-Villarroso J, et al. Metformin for obesity in prepubertal and pubertal children: a randomized controlled trial [published online June 12, 2017]. Pediatrics. doi:10.1542/peds.2016-4285