title: Effect of spironolactone and vitamin E on serum metabolic parameters and insulin resistance in patients with nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  The renin-angiotensin-aldosterone system has been implicated in the pathogenesis of insulin resistance and nonalcoholic fatty liver disease (NAFLD). The beneficial effect of spironolactone in a mouse model with diabetes and NAFLD has recently been reported. The main aim was assessment of the effect of spironolactone on serum metabolic parameters and insulin resistance in patients with NAFLD.
  
  
  METHODS
  This study includes preliminary results of a single-centre randomised controlled trial of treatment with vitamin E (group 1, 10 patients) versus spironolactone plus vitamin E (group 2, 10 patients) in biopsy-proven NAFLD. Serum transaminases, lipids, potassium, sodium, glucose and insulin were measured, and homeostatic model assessment-insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were calculated before and 8( )weeks after baseline assessment.
  
  
  RESULTS
  Insulin was decreased within group 2 (15.3 ± 2.7 at baseline vs. 10.3 ± 5.0 at week 8, p = 0.013). Although no difference in glucose was observed, HOMA-IR significantly decreased (4.4 ± 0.9 vs. 2.8 ± 0.5, respectively, p = 0.047). QUICKI was increased, but not statistically significantly.
  
  
  CONCLUSIONS
  Spironolactone and vitamin E combined therapy seems to exhibit a favourable effect on serum insulin and HOMA-IR in patients with NAFLD. If validated in a large-scale clinical trial, it may prove an inexpensive therapeutic approach for the management of NAFLD patients.
authors: Second Medical Clinic, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece. stergios@endo.gr
authors: Stergios A
authors: SA
authors: Polyzos
authors: Jannis
authors: J
authors: Kountouras
authors: Efthimia
authors: E
authors: Zafeiriadou
authors: Kalliopi
authors: K
authors: Patsiaoura
authors: Evangelia
authors: E
authors: Katsiki
authors: Georgia
authors: G
authors: Deretzi
authors: Christos
authors: C
authors: Zavos
authors: Georgios
authors: G
authors: Tsarouchas
authors: Pantelitsa
authors: P
authors: Rakitzi
authors: Aristidis
authors: A
authors: Slavakis
mesh_terms: D000818:Animals; D005234:Fatty Liver / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D051379:Mice; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D065626:Non-alcoholic Fatty Liver Disease; D013148:Spironolactone / Q000627:therapeutic use*; D014810:Vitamin E / Q000627:therapeutic use*
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D014810:Vitamin E; D013148:Spironolactone