Metformin in non-alcoholic steatohepatitis

There is no established treatment for steatohepatitis in patients who are not alcoholics. This disease is a potentially progressive liver disease associated with hepatic insulin resistance. Only a weight-reducing diet in overweight patients has proved effective. We treated 20 patients who had steato...

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Bibliographic Details
Published in:The Lancet (British edition) 2001-09, Vol.358 (9285), p.893-894
Main Authors: Marchesini, Giulio, Bianchi, Giampaolo, Tomassetti, Sara, Zoli, Marco, Melchionda, Nazario
Format: Article
Language:English
Subjects:
Adult
Alanine Transaminase - metabolism
Alcoholics
Animal models
Biological and medical sciences
Biopsy
Body Mass Index
Body weight
Body Weight - drug effects
Diabetes
Digestive system
Drug dosages
Drug therapy
Fatty liver
Fatty Liver - diet therapy
Fatty Liver - drug therapy
Fatty Liver - enzymology
Female
Glucose
Hepatitis
Humans
Hypoglycemic Agents - therapeutic use
Insulin
Insulin resistance
Liver
Liver diseases
Male
Medical research
Medical sciences
Metformin
Metformin - therapeutic use
Middle Aged
Obesity
Overweight
Patients
Pharmacology. Drug treatments
Sensitivity
Transaminase
Treatment Outcome
Ultrasonic imaging
Weight control
Weight reduction
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Summary:There is no established treatment for steatohepatitis in patients who are not alcoholics. This disease is a potentially progressive liver disease associated with hepatic insulin resistance. Only a weight-reducing diet in overweight patients has proved effective. We treated 20 patients who had steatohepatitis but were not alcoholics with metformin (500 mg three times a day for 4 months), an agent that improves hepatic insulin sensitivity. When compared with the six individuals not complying with treatment, long-term metformin significantly reduced mean transaminase concentrations, which returned to normal in 50% of actively-treated patients. Also, insulin sensitivity improved significantly and liver volume decreased by 20%. Similar data have been reported in insulin-resistant ob/ob mice with fatty liver. A randomised-controlled study is needed.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(01)06042-1