Clinical trial: insulin-sensitizing agents may reduce consequences of insulin resistance in individuals with non-alcoholic steatohepatitis.

Abstract

BACKGROUND:

Currently, although only a few therapies normalize the liver test abnormalities with/without improving the liver histology, no pharmacologic therapy has proved to be effective for the treatment of non-alcoholic steatohepatitis.

AIM:

To investigate the role of insulin sensitizers in the treatment of individuals with non-alcoholic steatohepatitis (NASH).

METHODS:

A total of 74 individuals with NASH (male/female, 44/30; mean age, 47.2 +/- 9.0 years) were enrolled. Participants were divided into two distinct groups: group 1 (n = 25) participants were administered a conventional diet and exercise programme while those in group 2 (n = 49) were administered the diet and exercise programme plus insulin sensitizers.

RESULTS:

With respect to baseline metabolic, biochemical and histological parameters, no significant differences were observed between the two groups (P > 0.05). Insulin sensitizers significantly improved metabolic parameters (homeostasis model assessment-insulin resistance score, P < 0.05), serum aminotransferase levels [aspartate aminotransferase (AST): 45.9 +/- 24.2 to 33.3 +/- 17.7 IU/L, P < 0.01; alanine aminotransferase (ALT): 78.2 +/- 46.3 to 47.3 +/- 34.5 IU/L, P < 0.001] and histological features (median non-alcoholic fatty liver disease activity score: 5.0-3.0, P = 0.01), while diet and exercise improved serum aminotransferase levels (AST: 39.3 +/- 11.1 to 30.0 +/- 8.6 IU/L, P < 0.01; ALT: 66.9 +/- 28.9 to 42.0 +/- 16.2 IU/L, P < 0.001) at the end of the 48 weeks when compared to baseline. Insulin sensitizers improved the high-sensitivity C-reactive protein levels (P < 0.01). No serious adverse effects of insulin sensitizers were observed.

CONCLUSION:

Insulin sensitizers can lead to improvement in metabolic, biochemical and histological abnormalities of NASH as a result of improved insulin sensitivity.

• Authors: R Idilman, D Mizrak, D Corapcioglu, M Bektas, B Doganay, M Sayki, S Coban, E Erden, I Soykan, R Emral, A R Uysal, A Ozden
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 28 Issue 2 Pg. 200-8 (Jul 2008) ISSN: 1365-2036 [Electronic] England
• PMID: 18445142 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Hypoglycemic Agents
• Thiazolidinediones
• Rosiglitazone
• Metformin
• Aspartate Aminotransferases
• Alanine Transaminase

Topics

• Adult
• Alanine Transaminase (blood, metabolism)
• Aspartate Aminotransferases (blood, metabolism)
• Diet Therapy
• Exercise Therapy
• Fatty Liver (drug therapy)
• Female
• Follow-Up Studies
• Humans
• Hypoglycemic Agents (therapeutic use)
• Insulin Resistance
• Male
• Metformin (therapeutic use)
• Middle Aged
• Rosiglitazone
• Thiazolidinediones (therapeutic use)
• Treatment Outcome