Lifestyle Intervention Improves Fitness Independent of Metformin in Obese Adolescents

• Autores: Corey A. Rynders, Arthur L. Weltman, Charles Delgiorno, Prabhakaran Balagopal, Ligeia Damaso
• Localización: Medicine & Science in Sports & exercise: Official Journal of the American College of Sports Medicine, ISSN 0195-9131, Vol. 44, Nº. 5, 2012, págs. 786-792
• Idioma: inglés
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  • Purpose: Obesity in adolescence increases the risk for early adult cardiovascular disease. We recently showed that 6 months of diet, exercise, and metformin resulted in reductions in adiposity and that diet/exercise alone reduced proinflammatory factors and intrahepatic fat in pubertal children with uncomplicated obesity. The purpose of the present study was to determine whether changes in cardiorespiratory fitness (CRF) after 6 months of structured diet and exercise (DE) or DE plus metformin are related to the previously observed changes in adiposity, markers of inflammation, and intrahepatic fat.

    Methods: Sixteen obese pubertal adolescents between the ages of 10 and 17 were randomized into a structured lifestyle program consisting of DE or DE plus metformin. Subjects performed aerobic and resistance exercise 3 d·wk-1, 30 min per session. Cycle ergometer maximal oxygen consumption (V?O2max), body composition, blood markers (glucose, insulin, homeostatic model assessment�insulin resistance, interleukin-6, hsCRP), and intrahepatic fat were measured at baseline and 6 months.

    Results: In the cohort, as whole-body weight decreased by 4.0% (P = 0.009), body mass index decreased by 4.9% (P = 0.003), percent body fat decreased by 8.8% (P < 0.001), and V?O2max improved in 10 of 16 subjects. The addition of metformin provided no further effect on body composition, CRF, or inflammatory factors. More favorable changes in adiposity, adiponectin, and a trend toward blood glucose and interleukin-6 concentrations (P = 0.07) were observed in subjects who increased V?O2max at 6 months (n = 10) compared with no change in these variables in those who did not improve V?O2max.

    Conclusions: Metformin did not provide benefits above lifestyle modification for improving CRF in obese adolescents. Improvements in V?O2max seem to be associated with more favorable metabolic outcomes.