The effects of rosiglitazone, metformin, and diet with exercise in nonalcoholic fatty liver disease

Our aim was to evaluate effects of metformin, rosiglitazone, and diet with exercise in nonalcoholic fatty liver disease. Forty-seven patients (mean age, 44+/-10 years; 17 female) whose ALT levels had been high for at least 6 months and with hepatosteatosis detected by liver biopsy and/or USG were en...

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Published in:Digestive diseases and sciences 2007-09, Vol.52 (9), p.2359-2367
Main Authors: AKYÜZ, Filiz, DEMIR, Kadir, MUNGAN, Zeynel, CEVIKBAS, Ugur, OKTEN, Atilla, ÖZDIL, Sadakat, AKSOY, Nevzat, POTUROGLU, Sule, IBRISIM, Duygu, KAYMAKOGLU, Sabahattin, BESISIK, Fatih, BOZTAS, Güngör, CAKALOGLU, Yilmaz
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Biopsy
Diet, Fat-Restricted
Dose-Response Relationship, Drug
Exercise Therapy
Fatty Liver - enzymology
Fatty Liver - pathology
Fatty Liver - therapy
Female
Follow-Up Studies
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Hypoglycemic Agents - administration & dosage
Hypoglycemic Agents - therapeutic use
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Metformin - administration & dosage
Metformin - therapeutic use
Middle Aged
Other diseases. Semiology
Thiazolidinediones - administration & dosage
Thiazolidinediones - therapeutic use
Transaminases - blood
Treatment Outcome
Vasodilator Agents
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Summary:Our aim was to evaluate effects of metformin, rosiglitazone, and diet with exercise in nonalcoholic fatty liver disease. Forty-seven patients (mean age, 44+/-10 years; 17 female) whose ALT levels had been high for at least 6 months and with hepatosteatosis detected by liver biopsy and/or USG were enrolled in this study. Of these, 12 were treated with 850 mg/day metformin (group 1), 11 with 4 mg/day rosiglitazone (group 2), and 24 with diet and exercise (group 3) for 1 year. ALT normalization at months 6 and 12 was accepted as treatment response. Liver biopsy was performed in all patients in groups 1 and 2 before treatment and 12 patients (4 in group 1, 8 in group 2) after treatment; but in group 3 it was performed only in patients who approved this procedure (12 patients). Body mass index did not change in groups 1 and 2, but it decreased significantly in group 3 (30+/-3 to 28+/-2 kg/m(2)) at month 12. Treatment response rate was 33.3, 54.5, and 54.2% in groups 1, 2, and 3, respectively, at month 6. This rate was 22.2, 37.5, and 41.2 in groups 1, 2, and 3, respectively, at month 12. Rate of steatosis and stage of fibrosis did not change after treatment. Diet with exercise seems to be superior to metformin and rosiglitazone. Decreasing treatment response at month 12 compared to month 6 may be due to fluctuations of ALT levels. Treatment response should be evaluated histologically.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-006-9145-x