title: Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary Syndrome.
abstract: Objective. Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance (IR), key features of nonalcoholic steatohepatitis (NASH). Cytokeratin 18 fragments (M30) have been established as a serum marker for NASH. The insulin sensitizer metformin improves hepatic IR. This study evaluates the influence of MF on serologic NASH (sNASH) in patients with PCOS. Patients and Methods. In 89 patients, metabolic parameters, liver injury indicating fatty liver (LIFL), and M30 were assessed at baseline and after metformin treatment. Patients with initial IR were subdivided into dissolved (PCOS-exIR) and persistent IR (PCOS-PIR) after treatment and compared to an initially insulin sensitive PCOS group (PCOS-C). Results. Improvement of LIFL prevalence could be seen in PCOS-C and PCOS-exIR compared to PCOS-PIR (-19.4, resp., -12.0% versus 7.2%, Chi(2) = 29.5, P < 0.001) without change in sNASH prevalence. In PCOS-PIR, ALT levels increased significantly accompanied by a nominal, nonsignificant M30 increase. Conclusions. Metformin improves LIFL in subgroups of patients with PCOS without influencing sNASH. This could either indicate a missing effect of metformin on NAFLD or slowed disease progression. Further studies are needed to elucidate NAFLD in the context of PCOS and potential therapeutic options.
authors: Department of Endocrinology and Division of Laboratory Research, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
authors: Susanne
authors: S
authors: Tan
authors: Department of Endocrinology and Division of Laboratory Research, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
authors: Nils
authors: N
authors: Vollmar
authors: Institute of Medical Psychology and Behavioral Immunobiology, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
authors: Sven
authors: S
authors: Benson
authors: Department of Gastroenterology and Hepatology, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
authors: Jan-Peter
authors: JP
authors: Sowa
authors: Department of Gastroenterology and Hepatology, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
authors: Lars P
authors: LP
authors: Bechmann
authors: Department of Gastroenterology and Hepatology, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
authors: Guido
authors: G
authors: Gerken
authors: Department of Endocrinology and Division of Laboratory Research, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
authors: Dagmar
authors: D
authors: Fuhrer
authors: Department of Gastroenterology and Hepatology, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, Germany.
authors: Ali
authors: A
authors: Canbay