Blood Glucose Levels And BMI In Very Obese Children Improved By Metformin

Main Category: Obesity / Weight Loss / Fitness
Also Included In: Diabetes;  Pediatrics / Children's Health
Article Date: 13 Dec 2012 - 0:00 PST Current ratings for:
Blood Glucose Levels And BMI In Very Obese Children Improved By Metformin

Metformin therapy has a beneficial treatment effect over placebo in improving body mass index (BMI) and fasting glucose levels in obese children, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). The study showed reduction in BMI was sustained for six months.

Childhood obesity has increased globally over the last two decades and it is linked to an increase in the diagnosis of type 2 diabetes in childhood, previously a condition that was only diagnosed in adults. Metformin is a first line drug for type 2 diabetes, and has been used for many decades. In adults metformin delays the onset of type 2 diabetes, but there is no evidence that the drug has a similar effect on children.

"Our findings provide evidence that a treatment course of metformin is clinically useful, safe and well-tolerated in obese children who are at risk for type 2 diabetes," said Deborah Kendall, MD, of Royal Manchester Children's Hospital in the United Kingdom and lead author of the study. "Metformin may also provide stimulus for lifestyle changes and potentially reduce long-term risk for type 2 diabetes and its associated health problems."

This prospective, randomized, double-blind, placebo-controlled trial was conducted at six pediatric endocrine centers in the United Kingdom and involved 151 obese children and young people with hyperinsulinemia and/or impaired fasting glucose or impaired glucose tolerance. Study participants received either metformin or placebo daily for six months. This trial is the largest of its kind to focus on metformin in obese non-diabetic children and young people.

"Our results show that metformin can improve BMI and blood glucose levels in obese children, but longer term effects such as reduction in the incidence of type 2 diabetes need further study," noted Kendall.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our obesity / weight loss / fitness section for the latest news on this subject.
Other researchers working on the study include: R. Amin, F. Ivison, A. McGovern, L. Tetlow, P. Clayton and C. Hall of Royal Manchester Children's Hospital; T. Barrett of Birmingham Children's Hospital, UK; P. Dimitri, J. Wales and N. Wright of the University of Sheffield, UK; M. Kibirige of The James Cook University Hospital, UK; V. Mathew of Hull Royal Infirmary, UK; K. Matyka and H. Stirling of University Hospital Coventry and Warwickshire National Health Service Trust, UK; and A. Vail of the Centre of Biostatistics, UK.

The article, "Metformin in Obese Children and Adolescents: The MOCA Trial," appears in the January 2013 issue of JCEM.

The Endocrine Society

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Newborns Delivered To Obese Mothers May Have Lower Levels Of Iron

Main Category: Pregnancy / Obstetrics
Also Included In: Obesity / Weight Loss / Fitness;  Pediatrics / Children's Health
Article Date: 11 Jul 2012 - 0:00 PDT Current ratings for:
Newborns Delivered To Obese Mothers May Have Lower Levels Of Iron

A growing number of studies imply that children born to obese mothers face health problems stemming from the womb.

New research from the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University and The Mother Infant Research Institute at Tufts Medical Center suggests that low iron status is among these health problems, according to an analysis of maternal hepcidin, a hormone that is key in keeping iron levels balanced.

The study enrolled 15 obese pregnant women with body mass index (BMI) greater than 30 and 15 healthy weight pregnant women with BMIs between 20 and 25 as a control group. Maternal blood draws took place during the second trimester of pregnancy and newborn iron status was measured in cord blood.

The researchers found that being born to an obese mother with elevated hepcidin levels was associated with lower iron status at birth. Obese adults are known to produce higher levels of hepcidin compared to healthy weight adults and the researchers suggest that overproduction of the hormone interferes with the transfer of iron from mother to infant. The results were recently published online by the Journal of Perinatology.

During pregnancy, hepcidin levels are kept at low levels to optimize iron transfer from mother to fetus. "When there is excess hepcidin in a cell, it binds to and inhibits the function of ferroportin, the protein that allows iron to pass through the cell membrane and into the bloodstream," explained senior author Simin Nikbin Meydani, DVM, PhD, director of the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University (USDA HNRCA).

"The chronic low-grade inflammation that can result from being obese triggers an abnormal immune response, increasing production of proteins that increase hepcidin levels," added Maria Carlota Dao, first author and a doctoral student in the Nutritional Immunology Laboratory at the USDA HNRCA. Because iron plays a crucial role in the formation of the central nervous system, children born with iron deficiency are at a greater risk for delays in motor and cognitive development.

"The data on the impact of low maternal iron levels on the fetus comes from undernourished populations," said first author Sarbattama Sen, MD, a neonatologist at Tufts Medical Center and an assistant professor of pediatrics at Tufts University School of Medicine (TUSM). "To the best of our knowledge, ours is the first study to demonstrate that obesity might hamper iron transfer from mother to child and offers some insight into the mechanism of how it occurs. Future studies, however, are needed to confirm the role of obesity associated with inflammation during pregnancy on hepcidin and iron status of the newborn."

The authors further stress that more research is needed before any changes to dietary guidelines or recommendations to obese pregnant women should be considered. Most prenatal vitamin supplements contain 27 milligrams of iron, the daily amount currently recommended by The American Congress of Obstetricians and Gynecologists.

"During pregnancy, women should try to eat a varied, healthy diet while taking the standard prenatal vitamins recommended by their doctors," Sen adds. "Weight gain goals should be based on a woman's BMI prior to becoming pregnant. In 2009, the Institute of Medicine issued new guidelines on weight gain during pregnancy."

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pregnancy / obstetrics section for the latest news on this subject. Simin Nikbin Meydani is also a professor at the Friedman School of Nutrition Science and Policy at Tufts University and is a member of the immunology program faculty at the Sackler School of Graduate Biomedical Sciences at Tufts University. Additional authors of this study are Chitra Iyer, MD, a former maternal fetal medicine fellow at Tufts Medical Center and David Klebenov, a TUSM student. .
The authors received funding for this study from the USDA, a Tufts Medical Center Research Grant, the Natalie V. Zucker Foundation for Women Scholars, the Stanley N. Gershoff Scholarship and the National Heart Lung and Blood Institute (NHLBI) T32 training program.
Dao MC, Sen S, Iyer C, Klebenov D, and Meydani SN. "Obesity During Pregnancy and Fetal Iron Status: Is Hepcidin the Link?" Journal of Perinatology advance online publication. June 21, 2012; doi: 10.1038/jp.2012.81.
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Lipoprotein Levels In Obese Patients With NAFLD Do Not Improve With Exercise

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Main Category: Liver Disease / Hepatitis
Also Included In: Obesity / Weight Loss / Fitness;  Sports Medicine / Fitness
Article Date: 29 May 2012 - 10:00 PDT Current ratings for:
'Lipoprotein Levels In Obese Patients With NAFLD Do Not Improve With Exercise'

Moderate physical activity does not improve lipoprotein concentrations in obese patients with non-alcoholic fatty liver disease (NAFLD), say researchers. The team found that in these patients, exercise only decreases triglyceride and alanine transaminase (ALT) levels by a small amount.

The study is published in Hepatology, a journal of the American Association for the Study of Liver Diseases.

According to the World Health Organization (WHO), in 2008, 1.5 billion individuals aged 20+ were overweight, and of these, 500 million were considered obese.

NAFLD is a common complication of obesity and can cause inflammation and scarring in the liver as well as liver failure. Earlier studies revealed that regular exercise and weight loss improved metabolic disturbances linked with NALFD.

In this study, Dr. Samuel Klein and his team from the Washington University School of Medicine in St. Louis, Mo., set out to determine how physical activity programs recommended by the Department of Health and Human Services impacted cholesterol, ALT, and triglyceride levels in obese patients with NALFD.

The researchers enrolled 18 obese patients with NAFLD to participate in the study. 12 participants were randomly assigned to the physical activity group and 6 were assigned to the control group. Those in the physical activity group engaged in 30-60 minutes of moderate exercise 5 days per week for 16 weeks.

The team evaluated how much physical exercise affected very low density lipoproteins (VLDL), intrahepatic triglyceride (IHTG), and apolipoprotein B-100 (apoB-100).

The researchers found that physical activity reduced IHTG content by 10%, but did not change body fat percentage or total body weight. Before the exercise program began, total body weight was 103.1 kg vs. 102.9 kg after, and total body fat was 38.9 vs. 39.2 after the exercise program.

No change in liver lipoprotein levels (VLDL or apoB-100) was found among participants in the physical activity group.

Dr. Klein concludes:

"Our data demonstrate that a moderate intensity exercise program followed by obese patients with NALFD causes a small decrease in IHTG content, even when body weight and total body fat mass are maintained.

Current exercise recommendations seem to have only a modest effect on triglycerides and ALT levels, suggesting that improvement in lipoprotein metabolism and fatty liver (steatosis) may be due to weight loss and not increased physical activity."

The researchers note that further research is required in order to assess the impact of moderate physical activity on IHTF content in individuals with NAFLD.

Written By Grace Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

'Lipoprotein Levels In Obese Patients With NAFLD Do Not Improve With Exercise'

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