Metformin and abdominal fat reduction
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Metformin and Abdominal Fat Reduction: Evidence from Clinical Studies
Metformin’s Impact on Visceral and Abdominal Fat in Different Populations
Multiple studies show that metformin can reduce abdominal and visceral fat in various populations, including children, adults, and those with specific metabolic conditions. In girls with low birth weight and early puberty, long-term metformin treatment led to significantly less total and visceral fat gain compared to untreated peers, as well as improved insulin sensitivity and a healthier lipid profile . Similarly, in obese women with and without polycystic ovary syndrome (PCOS), metformin combined with a hypocaloric diet resulted in greater reductions in body weight, BMI, and visceral adipose tissue compared to placebo, with notable improvements in insulin resistance and hormonal profiles .
In adults with prediabetes, chronic heart failure, and abdominal obesity, extended-release metformin for six months led to significant decreases in waist and hip circumference, body weight, BMI, and both subcutaneous and preperitoneal fat thickness, while also improving glucose metabolism . Meta-analyses and systematic reviews confirm that metformin produces modest but consistent reductions in BMI and body weight in both children and adults, with the most pronounced effects seen in those with higher baseline BMI 89.
Metformin in Combination Therapies and Abdominal Fat
When metformin is used as part of combination therapy, its effects on abdominal fat can vary depending on the added agent. Studies comparing metformin with SGLT2 inhibitors or GLP-1 receptor agonists (such as exenatide) found that while both combinations reduce overall body fat, the addition of GLP-1 agonists leads to greater reductions in abdominal fat compared to SGLT2 inhibitors . In patients with obesity and type 2 diabetes unresponsive to metformin alone, adding exenatide significantly reduced intra-abdominal fat and improved insulin resistance and inflammatory markers, whereas metformin with acarbose did not show the same degree of fat reduction .
Another study found that metformin alone or combined with dapagliflozin (an SGLT2 inhibitor) both reduced omental (abdominal) fat, but the combination was particularly effective in reducing perirenal fat, a depot linked to metabolic syndrome .
Effects in Children and Adolescents
In children with obesity and normal glucose tolerance, metformin added to diet and exercise led to greater weight loss and reduced abdominal adiposity compared to lifestyle intervention alone, although it did not further improve markers of inflammation or liver fat . Systematic reviews indicate that while metformin’s effect on BMI in children is generally smaller than in adults, it still provides a modest benefit, especially in those with higher baseline BMI or insulin resistance .
Mechanisms and Clinical Implications
Metformin’s ability to reduce abdominal and visceral fat is thought to be related to its effects on improving insulin sensitivity, reducing hyperinsulinemia, and possibly suppressing appetite, leading to decreased caloric intake . These changes not only help with weight and fat reduction but may also contribute to improved cardiovascular and metabolic health, particularly in individuals with insulin resistance or metabolic syndrome .
Conclusion
Overall, evidence from clinical trials and reviews supports that metformin can modestly reduce abdominal and visceral fat in both children and adults, with the greatest effects seen in those with higher baseline obesity or metabolic risk. The benefits are enhanced when metformin is combined with other agents like GLP-1 receptor agonists. These findings highlight metformin’s role as a valuable tool in managing abdominal obesity and its related metabolic complications 12345678+2 MORE.
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