Metformin in the treatment of non-alcoholic steatohepatitis: a pilot open label trial.

Abstract

BACKGROUND:

Insulin sensitizing agents may be useful in treatment of non-alcoholic fatty liver disease.

AIM:

A pilot study to evaluate the efficacy and safety of metformin in non-alcoholic fatty liver disease.

METHODS:

In an open labelled study, patients with histologically confirmed non-alcoholic fatty liver disease were given metformin (20 mg/kg) for 1 year. Insulin resistance (by log homeostasis assessment model analysis for insulin resistance and Quantitative Insulin Sensitivity Check Index) and post-treatment hepatic histology were compared with pre-treatment histology.

RESULTS:

Fifteen patients completed 1 year of treatment. During the initial 3 months, there was improvement in alanine aminotransferase and aspartate aminotransferase (P-value 0.01 and 0.02, respectively) along with improvement in insulin sensitivity. However, after 3 months, there was no further improvement in insulin sensitivity and there was gradual rise in aspartate aminotransferase and alanine aminotransferase back to pre-treatment levels. Among the 10 patients with post-treatment biopsy, three (33%), showed improvement in steatosis, two (20%) showed improvement in inflammation score and one (10%) showed improvement in fibrosis.

CONCLUSION:

Metformin treatment was associated with only a transient improvement in liver chemistries. A progressive, sustainable reduction in insulin sensitivity was not noted during treatment.

• Authors: S Nair, A M Diehl, M Wiseman, G H Farr Jr, R P Perrillo
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 20 Issue 1 Pg. 23-8 (Jul 01 2004) ISSN: 0269-2813 [Print] England
• PMID: 15225167 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Hypoglycemic Agents
• Metformin
• Aspartate Aminotransferases
• Alanine Transaminase

Topics

• Alanine Transaminase (metabolism)
• Aspartate Aminotransferases (metabolism)
• Drug Evaluation
• Female
• Hepatitis (drug therapy, enzymology)
• Humans
• Hypoglycemic Agents (administration & dosage, adverse effects)
• Insulin Resistance (physiology)
• Male
• Metformin (administration & dosage, adverse effects)
• Middle Aged
• Patient Compliance
• Pilot Projects
• Treatment Outcome