Metformin may be linked to a small increase in height in children and adolescents, according to randomized clinical trials that studied the largest cumulative doses of metformin. Findings from the study are published in JAMA Pediatrics.

Off-label use of metformin in children and adolescents has been increasing for conditions such as polycystic ovary syndrome, impaired glucose tolerance, nonalcoholic fatty liver disease, and obesity. Researchers from the University of Alberta, Canada, and colleagues evaluated 10 studies (n=562) with study participants having used metformin from 3–48 months. At baseline 59% were female, the average age ranged from nearly 8–16 years, and the average body mass index (BMI) ranged from 18.4–41.

Height changes were not significantly different between the metformin and control group participants. Further analyses showed, however, a 1cm increase in height associated with metformin use in the five studies providing the largest cumulative metformin doses but not in the five studies providing the lowest doses compared with the control group.

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Study limitations include the inability to obtain height measurements from many studies, though this information was collected for the reporting of BMI, researchers added. The 1cm height increase is likely to be underestimated due to many studies having a short duration and including older adolescents potentially after epiphyseal growth plate closure. Longer-term studies are needed in younger participants because these patients may exhibit greater increases in height compared with a control group, they concluded.

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