BACKGROUND: Non-alcoholic steatohepatitis (NASH) is a form of progressive fatty liver disease that is strongly associated with insulin resistance, which suggests that insulin sensitizing agents such as metformin may be beneficial for NASH. AIM: To assess the effects of metformin on insulin sensitivity, body composition, serum alanine aminotransferase (ALT) levels and liver histology in patients with NASH. METHODS: Patients underwent liver biopsy, metabolic profiling and imaging studies before and at the end 48 weeks of metformin (2000 mg/day) therapy. The primary endpoint was a three-point improvement in the histological NASH activity index. RESULTS: Of 28 patients enrolled, 26 (13 females; average age 44 years) completed 48 weeks of treatment and underwent repeat metabolic studies, imaging and liver biopsy. Thirty per cent achieved a histological response. Most patients lost weight, the average being 6 kg. There was a marked association between weight loss and improvements in NASH activity index and ALT levels (both, P < 0.01). Insulin sensitivity also improved, but the degree of change did not correlate with histological improvement. CONCLUSION: Metformin leads to improvements in liver histology and ALT levels in 30% of patients with NASH, probably by its effects in causing weight loss.
BACKGROUND:Non-alcoholic steatohepatitis (NASH) is a form of progressive fatty liver disease that is strongly associated with insulin resistance, which suggests that insulin sensitizing agents such as metformin may be beneficial for NASH. AIM: To assess the effects of metformin on insulin sensitivity, body composition, serum alanine aminotransferase (ALT) levels and liver histology in patients with NASH. METHODS:Patients underwent liver biopsy, metabolic profiling and imaging studies before and at the end 48 weeks of metformin (2000 mg/day) therapy. The primary endpoint was a three-point improvement in the histological NASH activity index. RESULTS: Of 28 patients enrolled, 26 (13 females; average age 44 years) completed 48 weeks of treatment and underwent repeat metabolic studies, imaging and liver biopsy. Thirty per cent achieved a histological response. Most patients lost weight, the average being 6 kg. There was a marked association between weight loss and improvements in NASH activity index and ALT levels (both, P < 0.01). Insulin sensitivity also improved, but the degree of change did not correlate with histological improvement. CONCLUSION:Metformin leads to improvements in liver histology and ALT levels in 30% of patients with NASH, probably by its effects in causing weight loss.
Authors: S H Caldwell; E E Hespenheide; J A Redick; J C Iezzoni; E H Battle; B L Sheppard Journal: Am J Gastroenterol Date: 2001-02 Impact factor: 10.864
Authors: R Pasquali; A Gambineri; D Biscotti; V Vicennati; L Gagliardi; D Colitta; S Fiorini; G E Cognigni; M Filicori; A M Morselli-Labate Journal: J Clin Endocrinol Metab Date: 2000-08 Impact factor: 5.958
Authors: William C Knowler; Elizabeth Barrett-Connor; Sarah E Fowler; Richard F Hamman; John M Lachin; Elizabeth A Walker; David M Nathan Journal: N Engl J Med Date: 2002-02-07 Impact factor: 91.245
Authors: Brent A Neuschwander-Tetri; Elizabeth M Brunt; Kent R Wehmeier; Dana Oliver; Bruce R Bacon Journal: Hepatology Date: 2003-10 Impact factor: 17.425
Authors: Rohit Loomba; Robert Wesley; Frank Pucino; T Jake Liang; David E Kleiner; Joel E Lavine Journal: Clin Gastroenterol Hepatol Date: 2008-07-25 Impact factor: 11.382
Authors: Kittichai Promrat; Glen Lutchman; Gabriel I Uwaifo; Renee J Freedman; Alejandro Soza; Theo Heller; Edward Doo; Marc Ghany; Ahalya Premkumar; Yoon Park; T Jake Liang; Jack A Yanovski; David E Kleiner; Jay H Hoofnagle Journal: Hepatology Date: 2004-01 Impact factor: 17.425
Authors: Ray C Boston; Darko Stefanovski; Peter J Moate; Anne E Sumner; Richard M Watanabe; Richard N Bergman Journal: Diabetes Technol Ther Date: 2003 Impact factor: 6.118