Gabriela Handzlik1, Michał Holecki2, Joanna Kozaczka3, Michał Kukla4, Katarzyna Wyskida5, Leszek Kędzierski3, Krzysztof Pawlicki6, Jan Duława3. 1. Department of Internal Medicine and Metabolic Diseases, School of Health Sciences, Medical University of Silesia, Katowice, Poland. Electronic address: ghandzlik-orlik@sum.edu.pl. 2. Department of Internal Medicine, Autoimmune and Metabolic Diseases, School of Medicine, Medical University of Silesia, Katowice, Poland. 3. Department of Internal Medicine and Metabolic Diseases, School of Health Sciences, Medical University of Silesia, Katowice, Poland. 4. Department of Gastroenterology and Hepatology, School of Medicine, Medical University of Silesia, Katowice, Poland. 5. Health Promotion and Obesity Management Unit, Department of Pathophysiology, School of Medicine, Medical University of Silesia, Katowice, Poland. 6. Department of Biophysics, School of Medicine, Medical University of Silesia, Katowice, Poland.
Abstract
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is among the most common causes of liver disease worldwide. There is growing evidence on pathogenesis and pathophysiology of NAFLD. However, there is still no universally accepted pharmacotherapy protocol. METHODS: The study was conducted on 42 patients with NAFLD. They were randomized to dietary treatment alone (n = 21) or to diet and metformin therapy (n = 21). Liver ultrasonography, controlled attenuation parameter (CAP), liver stiffness (LS), complete blood count, anthropometric and biochemical parameters were obtained before treatment (baseline), and after 3 and 5 months of the therapy. RESULTS: Patients treated with diet and metformin exhibited significantly decreased CAP values at 3 and 5 months of the therapy compared to baseline (319 dB/m vs. 285 dB/m; p < 0.05; 319 dB/m vs. 295 dB/m; p < 0.05 respectively). Five months of diet and the metformin therapy resulted in significant reduction of LS value (6.2 kPa vs. 5.2 kPa; p < 0.05), while patients treated with diet alone had no significant changes in liver CAP and LS measurements. CONCLUSIONS:Metformin therapy combined with dietary treatment seems to be effective for the reduction of hepatic steatosis and fibrosis. However, considering limitations of the study and inconsistent results of previous investigations in this area, there is a need for further research on metformin efficacy in this group of patients.
RCT Entities:
BACKGROUND:Non-alcoholic fatty liver disease (NAFLD) is among the most common causes of liver disease worldwide. There is growing evidence on pathogenesis and pathophysiology of NAFLD. However, there is still no universally accepted pharmacotherapy protocol. METHODS: The study was conducted on 42 patients with NAFLD. They were randomized to dietary treatment alone (n = 21) or to diet and metformin therapy (n = 21). Liver ultrasonography, controlled attenuation parameter (CAP), liver stiffness (LS), complete blood count, anthropometric and biochemical parameters were obtained before treatment (baseline), and after 3 and 5 months of the therapy. RESULTS:Patients treated with diet and metformin exhibited significantly decreased CAP values at 3 and 5 months of the therapy compared to baseline (319 dB/m vs. 285 dB/m; p < 0.05; 319 dB/m vs. 295 dB/m; p < 0.05 respectively). Five months of diet and the metformin therapy resulted in significant reduction of LS value (6.2 kPa vs. 5.2 kPa; p < 0.05), while patients treated with diet alone had no significant changes in liver CAP and LS measurements. CONCLUSIONS:Metformin therapy combined with dietary treatment seems to be effective for the reduction of hepatic steatosis and fibrosis. However, considering limitations of the study and inconsistent results of previous investigations in this area, there is a need for further research on metformin efficacy in this group of patients.
Authors: Valerio Rosato; Mario Masarone; Marcello Dallio; Alessandro Federico; Andrea Aglitti; Marcello Persico Journal: Int J Environ Res Public Health Date: 2019-09-14 Impact factor: 3.390