Non-alcoholic steatohepatitis (NASH) is a form of progressive fatty liver disease.
NASH is strongly associated with insulin resistance, which suggests that insulin sensitizing agents such as metformin may be beneficial.
Dr Hoofnagle and colleagues from Maryland, USA assessed the effects of metformin on insulin sensitivity, body composition, serum alanine aminotransferase levels and liver histology in patients with NASH.
Patients underwent liver biopsy, metabolic profiling and imaging studies before and at the end 48 weeks of metformin (2000 mg/day) therapy.
|30% achieved a histological response|
|Alimentary Pharmacology & Therapeutics|
The research team’s primary endpoint was a 3-point improvement in the histological NASH activity index.
Of 28 patients enrolled, 26 completed 48 weeks of treatment and underwent repeat metabolic studies, imaging and liver biopsy.
The researchers found that 30% achieved a histological response.
Most patients lost weight, the average being 6 kg.
There was a marked association between weight loss and improvements in NASH activity index and alanine aminotransferase levels.
The team noted that insulin sensitivity also improved, but the degree of change did not correlate with histological improvement.
Dr Hoofnagle’s team concludes, “Metformin leads to improvements in liver histology and alanine aminotransferase levels in 30% of patients with NASH, probably by its effects in causing weight loss.”