Efficacy of insulin-sensitizing agents in nonalcoholic fatty liver disease.
OBJECTIVE
To investigate the efficacy of insulin-sensitizing agents in nonalcoholic fatty liver disease (NAFLD) patients.


METHODS
This is an open-label, randomized, a single-center study. Sixty-four patients, with impaired glucose metabolism and elevated alanine aminotransferase for at least 6 months before enrollment and NAFLD activity score at least 5 in liver biopsy, were randomized as group 1 and received metformin 1700 mg/day, group 2 received rosiglitazone 4 mg/day, and group 3 received a combination of metformin 1700 mg/day and rosiglitazone 4 mg/day for 12 months.


RESULTS
Baseline demographic and laboratory findings were similar in all the three groups, except baseline insulin level that was significantly higher in group 1 and group 3 versus group 2 (P<0.05). Serum transaminase levels showed a significant decrease after treatment in both group 2 and group 3. Serum gamma-glutamyl transpeptidase levels decreased significantly only in the group 3. However, there was no significant change in liver tests of group 1. Postprandial glucose levels showed significant decrease in all of the three groups. Homeostasis model assessment-insulin resistance was reduced significantly in only group 2. NAFLD score was significantly decreased on follow-up biopsy of the patients in group 2 and group 3. Fibrosis did not change significantly after the treatment.


CONCLUSIONS
Rosiglitazone therapy seems to be more effective in metabolic control and histological improvement in NAFLD patients with impaired glucose metabolism.
Omer
Ziya
Z
Department of Internal Medicine, Ege University Medical School, Bornova, Izmir, Turkey.
Cetinkalp
Sevki
S
Akyildiz
Murat
M
Yilmaz
Funda
F
Batur
Yucel
Y
Yilmaz
Candeger
C
Akarca
Ulus
U
D000328:Adult; D001706:Biopsy; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004359:Drug Therapy, Combination; D005234:Fatty Liver / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D018149:Glucose Intolerance / Q000150:complications; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007333:Insulin Resistance; D008099:Liver / Q000473:pathology; D008297:Male; D008687:Metformin / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000009:adverse effects / Q000627:therapeutic use; D000637:Transaminases / Q000097:blood; D016896:Treatment Outcome; D005723:gamma-Glutamyltransferase / Q000097:blood
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D000077154:Rosiglitazone; D008687:Metformin; D005723:gamma-Glutamyltransferase; D000637:Transaminases