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. 2012 Aug;12(8):e6099.
doi: 10.5812/hepatmon.6099. Epub 2012 Aug 3.

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

Ali Akbar Hajiaghamohammadi  1 , Amir Ziaee, Sonia Oveisi, Homa Masroor
Affiliations

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

Ali Akbar Hajiaghamohammadi et al. Hepat Mon. 2012 Aug.

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.

Keywords: Cardiovascular System; Metformin; Non-Alcoholic Fatty Liver Disease; Pioglitazone; Silymarin.

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Figures

Figure 1
Figure 1. The Trial Profile of Patients Who Completed Follow Up
See this image and copyright information in PMC

References

    1. Al-Gharabally A, O’Brien CB, Acosta RC. A pilot study of pioglitazon for treatment of non-alcholic fatty liver disease. Hepat Mon. 2007;7(3):131–7.
    1. Serfaty L, Lemoine M. Definition and natural history of metabolic steatosis: clinical aspects of NAFLD, NASH and cirrhosis. Diabetes Metab. 2008;34(6 Pt 2):634–7. doi: 10.1016/S1262-3636(08)74597-X. - DOI - PubMed
    1. Farrell GC, van Rooyen D, Gan L, Chitturi S. NASH is an Inflammatory Disorder: Pathogenic, Prognostic and Therapeutic Implications. Gut Liver. 2012;6(2):149–71. doi: 10.5009/gnl.2012.6.2.149. - DOI - PMC - PubMed
    1. Glueck CJ, Moreira A, Goldenberg N, Sieve L, Wang P. Pioglitazone and metformin in obese women with polycystic ovary syndrome not optimally responsive to metformin. Hum Reprod. 2003;18(8):1618–25. doi: 10.1093/humrep/deg343. - DOI - PubMed
    1. Haas DA, Carr BR, Attia GR. Effects of metformin on body mass index, menstrual cyclicity, and ovulation induction in women with polycystic ovary syndrome. Fertil Steril. 2003;79(3):469–81. doi: 10.1016/S0015-0282(02)04800-8. - DOI - PubMed

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