Metformin in the treatment of patients with non-alcoholic steatohepatitis.
BACKGROUND
Increased insulin resistance is the major pathogenic mechanism in the development of non-alcoholic steatohepatitis.


OBJECTIVE
To investigate the therapeutic effect of metformin, a well-known insulin-sensitizing agent, in the treatment of non-alcoholic steatohepatitis.


METHODS
Thirty-six patients with non-alcoholic steatohepatitis were randomized into two groups. The first group was given lipid and calorie-restricted dietary treatment alone, and the second group was given metformin 850 mg b.d. plus dietary treatment, for 6 months. The changes in biochemical, sonographic and histological parameters were compared.


RESULTS
The mean serum alanine/aspartate aminotransferase, insulin and C-peptide levels decreased and the index of insulin resistance improved significantly from baseline in the group given metformin. The mean changes in these parameters in the metformin group were significantly greater than those in the group given dietary treatment alone. Although more patients in the metformin group showed improvement in the necro-inflammatory activity, compared with the group given dietary treatment alone, no significant differences in necro-inflammatory activity or fibrosis were seen between the groups.


CONCLUSIONS
The data suggest that improvement of the insulin sensitivity with metformin may improve the liver disease in patients with non-alcoholic steatohepatitis.
Department of Gastroenterology, Gulhane Military Medical Academy, Ankara, Turkey.
A
A
Uygun
A
A
Kadayifci
A T
AT
Isik
T
T
Ozgurtas
S
S
Deveci
A
A
Tuzun
Z
Z
Yesilova
M
M
Gulsen
K
K
Dagalp
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D002096:C-Peptide / Q000097:blood; D005260:Female; D006505:Hepatitis / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D008297:Male; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D045602:Steatorrhea / Q000188:drug therapy; D016896:Treatment Outcome
D001786:Blood Glucose; D002096:C-Peptide; D007004:Hypoglycemic Agents; D008687:Metformin