scholarly journals Role of Insulin Sensitizers in Raised Alanine Aminotransferase in Non-alcoholic Fatty Liver Disease in Glucose Intolerance Patients: A Short-Term Experience with Metformin Plus Pioglitazone Versus Metformin Alone

2015 ◽  
Vol 32 (4) ◽  
pp. 194-199
Author(s):  
Syeda Rezina Sultana ◽  
Mohammod Feroz Amin ◽  
Muhammad Abdur Rahim ◽  
Md Mahbubur Rahman ◽  
Md Nazmul Hoque ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Alanine Aminotransferase ◽  
Fatty Liver Disease ◽  
Fasting Blood Glucose ◽  
Combination Group ◽  
Alcoholic Fatty Liver ◽  
Number Of Patients ◽  
Group 2 ◽  
Group 1

Objectives:To evaluate and compare the effectiveness of metformin plus pioglitazone versus metformin alone in treatment of raised alanine aminotransferase (ALT) in nonalcoholic fatty liver disease (NAFLD) in patients with newly detected diabetes mellitus (DM) and impaired glucose tolerance (IGT).Materials and methods: In this open label clinical trial, newly detected DM and IGT patients with raised ALT and ultrasound proven NAFLD were treated with either metformin and pioglitazone combination (group 1) or metformin alone (group 2). They were followed up upto 6 months.Results:Total number of patients was 49 (27 in group 1 and 22 in group 2) and there was male predominance in either group. Age was almost identical between two groups (46±9.3 and 45.4±5.7 years in group 1 and group 2 respectively). Significant reduction in values of fasting blood glucose (FBG), 2 hours post breakfast values (ABF), HbA1c, cholesterol (CHOL), triglycerides (TG) and ALT of the study subjects were achieved in either group after six months (Group 1: FBG 8.89±1.4 vs 6.37±0.5 mmol/l, ABF 13.2±2.07 vs 8.34±0.84 mmol/l, HbA1c 8.15±0.87 % vs6.7±0.40%, CHOL 205.26±30.74 vs 178.89±18.59 mg/dl, TG 226.15±50.06 vs 155.85±20.99 mg/dl, ALT 91.52±23.14 vs 45.74±12.63 mg/dl and in Group 2 : FBG 9.39±2.26 vs 6.98±1.20 mmol/l, ABF 13.38±2.93 vs 9.13±1.46 mmol/l, HbA1c 8.10±0.92 % vs7.03±0.71%, CHOL 206.55±29.9 vs 195±23.55 mg/dl, TG 235.59±46.22 vs 178.91±38.24 mg/ dl, ALT 105.59±18.63 vs 66.36±16.02 mg/dl).In comparison between two groups, Group 1 had better metabolic control compared to their counterpart of Group 2 at the end of 6 months [Group 1 vs Group 2: FBG (p=0.024), ABF (p=0.022), CHOL (p = 0.010), TG (p =0.010)]. There was significant reduction in ALT as well (p = 0.000).Conclusion:Combination of metformin and pioglitazone is more effective than metformin alone in reducing ALT in NAFLD in newly detected DM and IGT patients.J Bangladesh Coll Phys Surg 2014; 32: 194-199

scholarly journals Combined use of metformin and Pioglitazone than metformin alone in Glucose intolerance patients with Nonalcoholic fatty liver disease showed significant Radiological and Biochemical improvement

2015 ◽  
Vol 22 (2) ◽  
pp. 188-194
Author(s):  
Mohammod Feroz Amin ◽  
Syeda Rezina Sultana ◽  
Indrajit Prasad ◽  
Muhammad Abdur Rahim ◽  
Md Anisur Rahman ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Final Visit ◽  
Open Label ◽  
Alcoholic Fatty Liver ◽  
Nonalcoholic Fatty Liver ◽  
Study Population ◽  
Group 2 ◽  
Group 1

Context: Non Alcoholic Fatty liver disease (NAFLD) is a hepatic manifestation of metabolic syndrome. The pathogenesis of steatosis and cellular injury is thought to be related mostly to insulin resistance. Insulin sensitizing drugs showed promising results in number of trials. This was an open label clinical trial in newly detected glucose intolerant patients with NAFLD, to evaluate the effectiveness and superiority of pioglitazone and metformin combination to metformin alone. Methods: Forty nine patients with newly detected abnormal glucose tolerance, naïve to any anti diabetic drug, were randomly selected, from the gastroenterology out-patient department of BIRDEM Hospital, Dhaka, with the findings of ultasonographic changes of fatty liver and raised ALT and assigned to 6 months treatment with pioglitazone 30 mg plus metformin 1700 mg daily (Group 1, n=27) or only metformin 1700 mg alone (Group 2, n=22). Results: Mean age of the study population was 45.80±8.54 years, Male female distribution of the study subjects were 65.3% and 34.7% respectively. Significant reduction of ALT, F, ABF, HbA1c, cholesterol, triglyceride of the study population were achieved either by metformin alone or with combination after six months (visit 1 vs visit 3, ALT: 97.99+22. vs 55±17.49 u/ l; Fasting sugar: 9.1+1.9 vs6.64±0.94, mmol/l; ABF: 13.3±2.5 vs 8.69±1.21 mmol/l; HBA1c: 8.1±0.9 vs 6.87±0.57%; Cholesterol: 205.9±30.1 vs 186.12±22.26 mg/dl; TG: 230.4+48.1 vs 166.2±31.82). In comparison between two groups, Group 1 had found to be significantly better glycemic control compared to their counterpart at the end of 6 months (Group 1 vs Group 2, FBG: 6.37±0.56 vs 6.98±1.2; ABF: 8.34±0.84 vs 9.1±1.46; serum cholesterol, TG, and ALT levels were also found to be significant change as Cholesterol: 178.89±18.59 vs 195±23.55 mg/dl; TG: 155.85±20.99 vs 178.91±38.24 mg/ dl; ALT: 55±17.49 vs 45.74±12.63 u/L. In final visit, ultrasonographic change also found to be significantlyimproved from fatty change to normal in patients with both metformin and pioglitazone group than patients on metformin alone. Conclusion: Treatment of NAFLD of newly detected Type 2 DM or IGT patients with high ALT by both metformin and pioglitazone is more effective in reduction of ALT and lipids and also able to reverse the severity of fatty changes of liver towards normal significantly. DOI: http://dx.doi.org/10.3329/jdmc.v22i2.21540 J Dhaka Medical College, Vol. 22, No.2, October, 2013, Page 188-194

scholarly journals Metabolic Syndrome in Adults with Nonalcoholic Fatty Liver Disease

2021 ◽  
Vol 5 (2) ◽  
pp. 34-37
Author(s):  
Zhahid Hassan ◽  
Muzamil Latief ◽  
Mahroosa Ramzan ◽  
Farhat Abbas ◽  
Summyia Farooq
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Care Hospital ◽  
Nonalcoholic Fatty Liver ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, obesity, and other features of metabolic syndrome. It is identified as the most common cause of liver enzyme derangement. Lately, NAFLD has generated interest in exploring treatment options, including weight loss and dietary interventions. An association of NAFLD with metabolic syndrome has been suggested in contemporary literature. In this study, we attempted to look into the association of NAFLD with metabolic syndrome. In this study, 80 adult NAFLD patients were recruited from a tertiary care hospital. Among these, 42 were males and 38 females with a mean age of 44.46±13.146 years (range 18–82 years). Grades of fatty liver and presence or absence of metabolic syndrome were studied in this patient population. Patients who did not qualify for the criteria of met-abolic syndrome were placed in Group 1 and those who fulfilled the stated criteria were considered in Group 2. There were 29 (36.25%) patients in Group 1 and 51 (63.75%) in Group 2. All the patients in Group 1 were having Grade I fatty liver whereas patients in Group 2 were found to having varying grades of fatty liver, with six patients having Grade III fatty liver. We found statistically significant difference in various parameters of study (liver enzymes, high-density lipoprotein (HDL), triglycerides, and blood pressure) between Group 1 and Group 2. Ultrasound evidence of a fatty liver should be considered as a predictor of metabolic syndrome, and these patients must be investigated for the different components of metabolic syndrome so as to have early diagnosis and intervention to alter development of long-term metabolic disorders and their inherent complications.

scholarly journals Real-world comorbidities and treatment patterns among patients with non-alcoholic fatty liver disease receiving phosphatidylcholine as adjunctive therapy in Russia

2019 ◽  
Vol 6 (1) ◽  
pp. e000307 ◽  
Author(s):  
Igor V Maev ◽  
Aleksey A Samsonov ◽  
Liudmila K Palgova ◽  
Chavdar S Pavlov ◽  
Elena Shirokova ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Alcoholic Fatty Liver ◽  
Number Of Patients ◽  
Metabolic Comorbidities ◽  
Alcoholic Fatty Liver Disease

ObjectivePrevious research conducted in Russia showed that the number of patients with non-alcoholic fatty liver disease (NAFLD) and associated metabolic comorbidities is large. We conducted an observational study to describe the management of NAFLD in patients with metabolic syndrome in Russia.DesignA total of 2843 adult patients from 174 medical sites across 6 federal districts of Russia with newly diagnosed NAFLD, who had at least one of four comorbidities, namely overweight/obesity, hypertension, type 2 diabetes mellitus, and hypercholesterolaemia, and who received phosphatidylcholine (PPC) as an adjunctive treatment to standard care, were enrolled during 2015–2016.ResultsOverall, 2263 patients (79.6%) had at least two metabolic comorbidities associated with NAFLD; overweight/obesity was the most common comorbidity reported in 2298 patients (80.8%). Simple steatosis was the most frequently identified clinical form of NAFLD, diagnosed in 2128 patients (74.9%). Among hypertensive patients, ACE inhibitors, statins, and sartans were most commonly prescribed. Biguanides were administered in more than half of diabetic patients. In patients with overweight/obesity and hypercholesterolaemia, statins were the most frequently prescribed medications. Almost all patients (2837/2843; 99.8%) were treated with 1.8 g of PPC three times per day. PPC therapy was associated with a 90.5% 6-month compliance rate, high treatment satisfaction, and a favourable safety profile. However, almost 15% of diabetic patients and 40% of overweight/obese patients received no further treatment.ConclusionsIn Russia, patients with newly diagnosed NAFLD represent a population heavily burdened by comorbidities, mainly overweight/obesity and hypercholesterolaemia. A significant part of these patients did not receive a comprehensive pharmacotherapy, highlighting the existing unmet need in the current management of NAFLD patients with metabolic syndrome in Russia.

scholarly journals Simple Resistance Exercise for 24 Weeks Decreases Alanine Aminotransferase Levels in Patients with Non-Alcoholic Fatty Liver Disease

2017 ◽  
Vol 01 (01) ◽  
pp. E2-E7 ◽  
Author(s):  
Atsushi Takahashi ◽  
Hiromichi Imaizumi ◽  
Manabu Hayashi ◽  
Ken Okai ◽  
Kazumichi Abe ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Resistance Exercise ◽  
Exercise Therapy ◽  
Alanine Aminotransferase ◽  
Fatty Liver Disease ◽  
Exercise Group ◽  
Control Group ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Abstract Exercise therapy is effective and recommended for non-alcoholic fatty liver disease (NAFLD) based on the efficacy of hepatic fat reduction. However, the efficacies of exercise therapy are based on short-term intervention. Moreover, no reports have examined whether significant reductions in serum levels of alanine aminotransferase (ALT) are achieved with exercise therapy in patients with NAFLD. The aim of this study is to assess the effects of simple resistance exercise for 24 weeks in NAFLD. 59 patients with NAFLD were assigned to a resistance exercise group (n=28) or a control group (n=31). The resistance exercise group performed 2 exercises (push-ups and squats) 3 times a week on nonconsecutive days for a trial periods of 24 weeks. Patients in the control group proceeded with regular physical activities under a restricted diet throughout the study. The effects of exercise were compared between groups after 24 weeks.Mean ALT level, homeostasis model assessment-estimated insulin resistance index and hepatic steatosis grade were all decreased in the resistance exercise group. Changes in ALT levels correlated negatively with changes in muscle:body weight ratio in the exercise group.These data demonstrate that 24 weeks of simple resistance exercise comprising squats and push-ups represents an effective treatment for NAFLD.

scholarly journals THE RELATIONSHIP OF DIABETIC CONTROL WITH SERUM ALANINE AMINOTRANSFERASE LEVELS IN PATIENTS WITH NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) AND TYPE 2 DIABETES MELLITUS (T2DM)

2021 ◽  
Vol 29 (01) ◽  
pp. 10-12
Author(s):  
Saleem Iqbal ◽  
Hamza Ali Khan ◽  
Muhammad Yousaf Khan ◽  
Muhammad Darwesh Iqbal ◽  
Badar Mahmud Shah ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver ◽  
Alanine Aminotransferase ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Serum Alanine Aminotransferase

ABSTRACT Objectives This study is aimed to find out the relation of Diabetic control with serum Alanine aminotransferase in patients with Non Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus. Material and methods This cross sectional descriptive study was conducted from August to October 2019 in general medical outpatient department of Khyber Teaching Hospital Peshawar, a tertiary care hospital in Khyberpakhtunkhwa, Pakistan. Patients with non Alcohohol Fatty Liver Disease and T2DM were categorized into two groups. Group A with HbA1c from 6.5-8% and group B with HbA1c of more than 8%. Serum Alanine aminotransferase levels were correlated in these groups with the level of HbA1c. Data was collected through a specially designed proforma and was analyzed through statistical package for social sciences, SPSS version 23. Results Amongst 452 patients with T2DM, 289 were females and the rest of 163 were males, NAFLD was present in 197 patients. Amongst these 197 patients Serum Alanine aminotransferase was raised in 17 (27.86%) patients in Group A but was raised in 64 (47.05%) patients in Group 2. Conclusions Diabetic control was positively correlated with serum Alanine aminotransferase level in our patients with Non Alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus. Keywords Type 2 Diabetes Mellitus, Non Alcoholic Fatty Liver Disease, Serum Alanine Aminotransferase.

Sign in / Sign up

Export Citation Format

Share Document