Metformin and Diammonium Glycyrrhizinate Enteric-Coated Capsule versus Metformin Alone versus Diammonium Glycyrrhizinate Enteric-Coated Capsule Alone in Patients with Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus.

Rong Zhang,Sainan Li,Tong Liu,Jiao Feng,Jingjing Li,Shunfeng Zhou,Jie Lu,Yingqun Zhou,Yuqing Zhou,Yujing Xia,Rui Kong,Shizan Xu,Liwei Wu,Chuanyong Guo,Keran Cheng,Linqiang Li

doi:10.1155/2017/8491742

Abstract

Objective. The present study was conducted to compare the efficacy of metformin combined with diammonium glycyrrhizinate enteric-coated capsule (DGEC) versus metformin alone versus DGEC alone for the treatment of nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM). Subjects and Methods. 163 patients with NAFLD and T2DM were enrolled in this 24-week study and were randomized to one of three groups: group 1 was treated with metformin alone; group 2 was treated with DGEC alone; group 3 received metformin plus DGEC combination therapy. Anthropometric parameters, liver function, lipid profile, serum ferritin (SF), metabolic parameters, liver/spleen computed tomography (CT) ratio, and fibroscan value were evaluated at baseline and after 8, 16, and 24 weeks of treatment. Results. After 24 weeks, significant improvements in all measured parameters were observed in three groups (P < 0.05) except for the improvements in low density lipoprotein cholesterol (LDL-C) and metabolic parameters in group 2 which did not reach statistical significance (P > 0.05). Compared with group 1 and group 2, the patients in group 3 had greater reductions in observed parameters apart from CB and TB (P < 0.05). Conclusions. This study showed that metformin plus DGEC was more effective than metformin alone or DGEC alone in reducing liver enzymes, lipid levels, and metabolic parameters and ameliorating the degree of hepatic fibrosis in patients with NAFLD and T2DM.

Highlights

Nonalcoholic fatty liver disease (NAFLD) is currently the most common comorbidity and cause of chronic liver disease in adults
All demographic and biochemical parameters at baseline were similar in the three groups in terms of gender, age, liver function, and metabolic parameters
No statistically significant differences were observed between the three groups with respect to anthropometric parameters, BMI, liver function (ALT, AST, and gamma glutamine transpeptidase (GGT)), lipid profile (HbA1c, fasting blood glucose (FBG), and fasting insulin (FINS)), serum ferritin (SF), liver/spleen computed tomography (CT) ratio, and fibroscan value (Table 1)

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is currently the most common comorbidity and cause of chronic liver disease in adults. NAFLD is accompanied by a range of metabolic comorbidities such as visceral obesity, hyperlipidemia, insulin resistance (IR)/diabetes mellitus, and hypertension and is considered a manifestation of the metabolic syndrome (MS) in liver [2, 8]. The prevalence of type 2 diabetes mellitus (T2DM) in patients with NAFLD can reach 70%, and in turn, T2DM increases the risk of NAFLD [9]. With an increase in the rate of urbanization and inappropriate lifestyle changes in modern society, people have a high risk of developing NAFLD due to the growing prevalence of obesity and T2DM [10]. Metformin prescribed in patients with NAFLD and T2DM causes weight loss, reduces liver transaminases, and improves hepatomegaly and IR or insulin secretion [14,15,16], whereas improvements in histology remain controversial [17, 18]. The use of thiazolidinediones is restricted due to side effects (ischemic heart disease, heart failure, potential hepatotoxicity, liver failure, weight gain, edema, low bone mineral density, and an increased risk of bladder cancer) [19]

Methods

Results

Conclusion