Metformin in non-alcoholic steatohepatitis.
There is no established treatment for steatohepatitis in patients who are not alcoholics. This disease is a potentially progressive liver disease associated with hepatic insulin resistance. Only a weight-reducing diet in overweight patients has proved effective. We treated 20 patients who had steatohepatitis but were not alcoholics with metformin (500 mg three times a day for 4 months), an agent that improves hepatic insulin sensitivity. When compared with the six individuals not complying with treatment, long-term metformin significantly reduced mean transaminase concentrations, which returned to normal in 50% of actively-treated patients. Also, insulin sensitivity improved significantly and liver volume decreased by 20%. Similar data have been reported in insulin-resistant ob/ob mice with fatty liver. A randomised-controlled study is needed.
Marchesini
G
G
Brizi
M
M
Bianchi
G
G
Tomassetti
S
S
Zoli
M
M
Melchionda
N
N
D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D005234:Fatty Liver / Q000178:diet therapy* / Q000188:drug therapy* / Q000201:enzymology; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D008687:Metformin; D000410:Alanine Transaminase