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J Clin Endocrinol Metab. 2017 Jan 1;102(1):132-140. doi: 10.1210/jc.2016-2701.

Effects of Conjugated Linoleic Acid and Metformin on Insulin Sensitivity in Obese Children: Randomized Clinical Trial.

Author information

1
Children and Adolescent Obesity Clinic.
2
Department of Human Genetics, Hospital General de México Eduardo Liceaga-Facultad de Medicina, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico.
3
Research Unit, and.
4
Specialized Center for Diabetes Control, Public Health Services, Mexico City, Mexico 11340.
5
Basic Medical Sciences Department, TEC-ABC School of Medicine, Tecnológico de Monterrey, Mexico 05300; and.
6
School of Medicine, South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Edinburg, Texas 78539.
7
Department of Surgery, Hospital General de México Eduardo Liceaga, 06726 Mexico City, Mexico.

Abstract

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.

PMID:
27778642
DOI:
10.1210/jc.2016-2701
[Indexed for MEDLINE]

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