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Metabolic Effect of Metformin in Obese Insulin Resistant Adolescents With Normal Glucose Tolerance

This study has been completed.
Sponsor:
Collaborator:
National Institutes of Health (NIH)
Information provided by:
Yale University
ClinicalTrials.gov Identifier:
NCT00667498
First received: April 24, 2008
Last updated: February 16, 2009
Last verified: February 2009
  Purpose
The primary objective of this randomized, parallel group, double-blind, placebo-controlled study is to determine whether treatment with metformin enhances insulin sensitivity in a group of ethnically diverse obese insulin-resistant adolescents with normal glucose tolerance.

Condition Intervention Phase
Pediatric Obesity
Insulin Resistance
Hyperinsulinemia
Drug: Metformin
Drug: Placebo
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: Metabolic Effect of Metformin in Obese Insulin Resistant Adolescents With Normal Glucose Tolerance

Resource links provided by NLM:


Further study details as provided by Yale University:

Primary Outcome Measures:
  • Assessment of insulin sensitivity: Whole Body Insulin Sensitivity Index (WBISI), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and Euglycemic hyperinsulinemic clamp [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]

Secondary Outcome Measures:
  • Body mass index (BMI) [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Waist to hip circumference ratio [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Muscle lipid content [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Total body fat [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Abdominal fat mass [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Hepatic fat fraction [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Hepatic iron concentration [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Plasma ghrelin levels [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Adiponectin levels [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Leptin levels [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Blood pressure [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Lipid profile [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Microalbuminuria [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Inflammatory markers (Plasminogen activator inhibitor-1 (PAI-1), C-reactive protein (CRP), homocysteine, tumor necrosis factor (TNF)-α, Interleukin (IL)-6) [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Self-paced step test (Heart rate recovery after exercise) [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Peripheral Arterial Tonometry (PAT) [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Females only: Markers of polycystic ovarian syndrome (PCOS) - Adrenal androgens (17 Hydroxyprogesterone, Dehydroepiandrosterone), sex hormone binding globulin (SHBG), free testosterone, LH/FSH ratio [ Time Frame: Baseline (month 0), post 3-month intervention (month 4), and post 6-month extension (month 10). ]
  • Females only: Menstrual pattern [ Time Frame: Throughout study ]
  • Ethnic stratification (Hispanic, African American or Caucasian) [ Time Frame: Baseline (month 0) ]

Enrollment: 28
Study Start Date: March 2004
Study Completion Date: December 2007
Primary Completion Date: December 2007 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1 Drug: Metformin

The subject will receive either metformin or placebo drug, given as 500mg tablets (or corresponding placebos) necessary to increase the dose incrementally over a three week period.

The time it takes to incrementally increase the dose to the desired dose of 500mg in am and 1000mg in pm will count as intervention time. Both the metformin and placebo group will also be given a multivitamin with vitamin B12 to avoid potential anemia.

Other Name: Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet
Placebo Comparator: 2 Drug: Placebo

The subject will receive either metformin or placebo drug, given as 500mg tablets (or corresponding placebos) necessary to increase the dose incrementally over a three week period.

The time it takes to incrementally increase the dose to the desired dose of 500mg in am and 1000mg in pm will count as intervention time. Both the metformin and placebo group will also be given a multivitamin with vitamin B12 to avoid potential anemia.


  Show Detailed Description

  Eligibility

Ages Eligible for Study:   13 Years to 17 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Attending weight management clinic at Yale New Haven Hospital
  • Good general health, taking no other medication on a chronic basis
  • Age 13 to 17 yrs in puberty (girls: breast Tanner stage II to IV, and boys: testes size > 6 ml)
  • The presence of insulin resistance, defined by fasting insulin levels greater than 30 µU/ml, and HOMA insulin resistance index > 6
  • Normal glucose tolerance based on a 2-hr plasma glucose (<140 mg/dl) after the OGTT.
  • All female subjects must have a negative urine pregnancy test during the study visits and must use an effective method of contraception if they are sexually active. Without their parent(s) present, all potential female subjects will be asked about their sexual activity and the specific form of contraception they are using.

Exclusion Criteria:

  • Baseline creatinine > 1.0 mg/dl
  • Hepatic disease with elevated liver function test (ALT or AST) ≥ 2 X the upper limits of normal
  • Pregnancy
  • Presence of other endocrinopathies; except treated hypothyroidism on stable replacement doses of thyroid hormone
  • Presence of cardiac, pulmonary or other significant chronic illness
  • Adolescents with psychiatric disorder, claustrophobia or with substance abuse
  • Recent use (within six months) of anorexic agents
  • Presence of anemia (hematocrit < 35)
  • Mixed ethnic background (defined as two parents of different ethnicity)
  • Adolescents with metal implants (i.e. cardiac pace maker, metal prostheses, bullet remnants)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00667498

Locations
United States, Connecticut
Yale Center for Clinical Investigation (YCCI)
New Haven, Connecticut, United States, 06511
Sponsors and Collaborators
Yale University
National Institutes of Health (NIH)
Investigators
Principal Investigator: Tania S Burgert, MD Yale University Medical School
  More Information

Publications:
Responsible Party: Tania S. Burgert, M.D., Yale University
ClinicalTrials.gov Identifier: NCT00667498     History of Changes
Other Study ID Numbers: 0311026134
Study First Received: April 24, 2008
Last Updated: February 16, 2009

Keywords provided by Yale University:
Pediatric Obesity
Insulin Resistance
Hyperinsulinemia
Metformin
Glucose Tolerance
Microalbuminuria
Adolescents
Visceral Fat

Additional relevant MeSH terms:
Insulin Resistance
Hyperinsulinism
Pediatric Obesity
Glucose Metabolism Disorders
Metabolic Diseases
Obesity
Overnutrition
Nutrition Disorders
Overweight
Body Weight
Signs and Symptoms
Insulin
Metformin
Hypoglycemic Agents
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on May 25, 2017