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Effects of metformin, pioglitazone, and silymarin treatment on non-alcoholic Fatty liver disease: a randomized controlled pilot study.

Hajiaghamohammadi AA, Ziaee A, Oveisi S, Masroor H - Hepat Mon (2012)

Bottom Line: First group was treated by pioglitazone 15 mg/d, second group by metformin 500 mg/d, and third group by silymarin 140 mg/d.The most reduction in average FBS, TG, serum insulin level, and HOMA index was observed in pioglitazone group, the most reduction in average amount of cholesterol was seen in metformin group, and the most decrease in average amount of AST and ALT occurred in silymarin group.Changes in AST and ALT in silymarin group were demonstrated more than that in other groups and the average difference between changes was significant between silymarin and metformin groups.

View Article: PubMed Central - PubMed

Affiliation: Metabolic Disease Research Center, Qazvin University of Medical Science, Qazvin, IR Iran.

ABSTRACT

Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common reasons of enzyme increase in liver. In About 10 percent of patients with NAFLD, the disease progresses toward Non Alcoholic Steatohepatitis (NASH) and about one third of them may progress toward cirrhosis, liver dysfunction, and even hepatocellular carcinoma.

Objectives: According to high prevalence of NAFLD and the fact that there is no consensus on treatment of this disease, the aim of this study was to assess the effects of metformin, pioglitazone, and silymarin on treatment of NAFLD.

Patients and methods: Sixty six patients with NAFLD who were presented in the Endocrinology and Metabolism clinic of Boo'ali Hospital, Qazvin, Iran, were assigned randomly into three groups (n = 22). First group was treated by pioglitazone 15 mg/d, second group by metformin 500 mg/d, and third group by silymarin 140 mg/d. All patients underwent clinical and biochemical evaluations including weight, fasting blood sugar (FBS), lipid profiles, body mass index (BMI), aspartate aminotransferase (AST ), alanine aminotransferase (ALT), and serum insulin levels in pre- and post-intervention after eight-week follow up.

Results: Before the treatment there was no significant difference between three groups with respect to average age, BMI and gender, FBS, lipid profile, AST, ALT, serum insulin level, and Homeostasis Model Assessment (HOMA) index for insulin resistance. After the intervention, a significant reduction was observed in average amount of FBS, lipid profile, ALT, AST, serum insulin level and HOMA index in three groups (P < 0.01). The most reduction in average FBS, TG, serum insulin level, and HOMA index was observed in pioglitazone group, the most reduction in average amount of cholesterol was seen in metformin group, and the most decrease in average amount of AST and ALT occurred in silymarin group.

Conclusions: These results suggest that all drugs are beneficial in improving biochemical indices in patients with NAFLD. Changes in AST and ALT in silymarin group were demonstrated more than that in other groups and the average difference between changes was significant between silymarin and metformin groups.

No MeSH data available.


Related in: MedlinePlus

The Trial Profile of Patients Who Completed Follow Up
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fig111: The Trial Profile of Patients Who Completed Follow Up

Mentions: This study was conducted in Qazvin, Iran. Sixty six patients (males = 42 and females = 24) who were presented in Endocrinology and Metabolism clinic of Boo’ali Hospital, Qazvin University of Medical Sciences from 2010 to 2011 were studied. Patients suffered from NAFLD (Mean age = 32.62 years, SD = 6.4 years) and their trial profileis shown in Figure 1. Some characteristics and parameters of participants are shown in Table 1. All participants provided written informed consent before enrolment and all responses were kept confidential. The ethics review board of Qazvin University of Medical Science approved the study. Inclusion criteria were infliction with NAFLD Confirmed by performing liver sonography and increased levels of liver enzymes AST and ALT. All tests and sonographies were conducted in one center. In addition to obtaining complete history on taking alcohol and drugs, the tests related to autoimmune hepatitis and virus markers were also applied for all patients. Patients having history of alcohol consumption, diabetes, chronic liver disease, use of drugs such as statin, fibrate, NSAID, and those with positive results for tests of autoimmune hepatitis and virus markers (HBS antigen. HCV antibody) were excluded from the study.


Effects of metformin, pioglitazone, and silymarin treatment on non-alcoholic Fatty liver disease: a randomized controlled pilot study.

Hajiaghamohammadi AA, Ziaee A, Oveisi S, Masroor H - Hepat Mon (2012)

The Trial Profile of Patients Who Completed Follow Up
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3475019&req=5

fig111: The Trial Profile of Patients Who Completed Follow Up
Mentions: This study was conducted in Qazvin, Iran. Sixty six patients (males = 42 and females = 24) who were presented in Endocrinology and Metabolism clinic of Boo’ali Hospital, Qazvin University of Medical Sciences from 2010 to 2011 were studied. Patients suffered from NAFLD (Mean age = 32.62 years, SD = 6.4 years) and their trial profileis shown in Figure 1. Some characteristics and parameters of participants are shown in Table 1. All participants provided written informed consent before enrolment and all responses were kept confidential. The ethics review board of Qazvin University of Medical Science approved the study. Inclusion criteria were infliction with NAFLD Confirmed by performing liver sonography and increased levels of liver enzymes AST and ALT. All tests and sonographies were conducted in one center. In addition to obtaining complete history on taking alcohol and drugs, the tests related to autoimmune hepatitis and virus markers were also applied for all patients. Patients having history of alcohol consumption, diabetes, chronic liver disease, use of drugs such as statin, fibrate, NSAID, and those with positive results for tests of autoimmune hepatitis and virus markers (HBS antigen. HCV antibody) were excluded from the study.

Bottom Line: First group was treated by pioglitazone 15 mg/d, second group by metformin 500 mg/d, and third group by silymarin 140 mg/d.The most reduction in average FBS, TG, serum insulin level, and HOMA index was observed in pioglitazone group, the most reduction in average amount of cholesterol was seen in metformin group, and the most decrease in average amount of AST and ALT occurred in silymarin group.Changes in AST and ALT in silymarin group were demonstrated more than that in other groups and the average difference between changes was significant between silymarin and metformin groups.

View Article: PubMed Central - PubMed

Affiliation: Metabolic Disease Research Center, Qazvin University of Medical Science, Qazvin, IR Iran.

ABSTRACT

Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common reasons of enzyme increase in liver. In About 10 percent of patients with NAFLD, the disease progresses toward Non Alcoholic Steatohepatitis (NASH) and about one third of them may progress toward cirrhosis, liver dysfunction, and even hepatocellular carcinoma.

Objectives: According to high prevalence of NAFLD and the fact that there is no consensus on treatment of this disease, the aim of this study was to assess the effects of metformin, pioglitazone, and silymarin on treatment of NAFLD.

Patients and methods: Sixty six patients with NAFLD who were presented in the Endocrinology and Metabolism clinic of Boo'ali Hospital, Qazvin, Iran, were assigned randomly into three groups (n = 22). First group was treated by pioglitazone 15 mg/d, second group by metformin 500 mg/d, and third group by silymarin 140 mg/d. All patients underwent clinical and biochemical evaluations including weight, fasting blood sugar (FBS), lipid profiles, body mass index (BMI), aspartate aminotransferase (AST ), alanine aminotransferase (ALT), and serum insulin levels in pre- and post-intervention after eight-week follow up.

Results: Before the treatment there was no significant difference between three groups with respect to average age, BMI and gender, FBS, lipid profile, AST, ALT, serum insulin level, and Homeostasis Model Assessment (HOMA) index for insulin resistance. After the intervention, a significant reduction was observed in average amount of FBS, lipid profile, ALT, AST, serum insulin level and HOMA index in three groups (P < 0.01). The most reduction in average FBS, TG, serum insulin level, and HOMA index was observed in pioglitazone group, the most reduction in average amount of cholesterol was seen in metformin group, and the most decrease in average amount of AST and ALT occurred in silymarin group.

Conclusions: These results suggest that all drugs are beneficial in improving biochemical indices in patients with NAFLD. Changes in AST and ALT in silymarin group were demonstrated more than that in other groups and the average difference between changes was significant between silymarin and metformin groups.

No MeSH data available.


Related in: MedlinePlus