A comparison of treatments offered to patients with nonalcoholic steatohepatitis.
OBJECTIVE
To compare various treatment options provided to patients with Nonalcoholic Steatohepatitis (NASH) and assess improvement in liver status via reduction in serum Alanine Aminotransferase (ALT) levels.


METHODS
Retrospective cohort study.


METHODS
The Aga Khan University Hospital, Karachi, from April 2000 to April 2007.


METHODS
All available records of patients aged between 20-70 years, fatty liver on ultrasound, elevated serum ALT and having at least one follow-up, after a baseline visit were included. The patients had variable number of follow-ups and a maximum of 3 follow-ups were considered. Information was collected on demographic and clinical characteristics of the subjects. The treatment options were categorized as weight reduction alone, with statins, and with other medications. Serum ALT level was the main outcome measured in IU/l. Repeated-measures ANOVA, using a mixed model approach was performed with treatment options as between subject factor, and follow-up as within subject factor and p-value < 0.05 was considered significant.


RESULTS
Sixty-nine records of subjects, consisting of 50 males and 19 females were selected. The mean (+/- SD) age was 40+/-12 years. Thirty-one subjects (45%) were advised weight reduction only, and experienced a 72% reduction in serum ALT levels, over the mean follow-up time of 9+/-3 months. Twelve subjects (17%) received statins along with weight reducing advice, and experienced a 56% reduction in mean ALT over the mean follow-up of 11+/-7 months. Twenty-six subjects (38%) received other medications along with advice for weight reduction and experienced a 73% reduction in serum ALT levels over the mean time of 10+/-4 months. The mean ALT declined at follow-up times, irrespective of the prescribed treatment, and that the decline with time was different for males and females.


CONCLUSIONS
Serum ALT levels among patients with NASH decreased with time, regardless of the provided treatment, and the decrease was different for males and females.
Iqbal
Saleem Perwaiz
SP
Department of Paediatrics and Child Health, The Aga Khan University Hospital, Karachi. saleem.iqbal@aku.edu
Mahmud
Sadia
S
Hamid
Saeed
S
Pasha
Omrana
O
Ahmad
Khabir
K
D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D015331:Cohort Studies; D005234:Fatty Liver / Q000628:therapy*; D005260:Female; D006505:Hepatitis / Q000628:therapy; D006801:Humans; D008103:Liver Cirrhosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D000410:Alanine Transaminase