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Metformin Effect on Height in Children and Adolescents

Higher doses of medication may lead to a mean increase of approximately 1 cm height.

Metformin use is increasing in children and adolescents. The effects of metformin use on body mass index changes have been studied, but no consideration has been made to the effects of metformin in height.

The objective of this study is to conduct a systematic review and meta-analysis of metformin use on height in children and adolescents. This study had 562 participants with 58.6% (330) of them being females. Participants were 19 years of age and younger. They were observed anywhere from 3 to 48 months. A total of ten studies were included.

The endpoint, height changes, were not significantly different between metformin and the control groups. However, when the studies were divided into subgroups based on higher and lowers cumulative doses, the five studies exposed to higher dose of metformin demonstrated an association of a decrease in body mass index at a weighted mean difference of -1.3 (95% confidence interval, -2.1 to -0.4) and an increase in height at a weighted mean difference of 1.0 cm (95% confidence interval, 0.0-2.0 cm) in comparison with the control groups. There was no significant effect on weight.

A possibility is that the epiphyseal growth plate closure may have already been reached in participants of the subgroups in these studies. Those participants would be unlikely to have additional growth caused by metformin treatment adverse effects.

According to this study there was no clinical significance in height changes. However, according to a stratified analysis of the cumulative dose of metformin in children and adolescents, there’s an increase by height in comparison to peers who did not receive metformin. A larger group of study with pubertal participants may reveal that metformin administration during puberty could enhance or prolong the normally occurring, puberty-induced height change.

Practice Pearls:

  • Meta-analysis studies on the correlation between metformin and body mass index changes have been conducted, but before this study none considered the metformin effects on height changed in children and adolescents.
  • There was no clinical significance in height changed between metformin users group and the control group.
  • Accumulation of metformin usage in higher doses may lead to a mean increase of approximately 1 cm height increase in children and adolescents.

JAMA Pediatrics. “Evaluating the Effects of Metformin Use on Height in Children and Adolescents. A Meta-analysis of Randomized Clinical Trials.” Web. 28 Sept. 2015.