Endocrinology Unit, Department of Clinical and Experimental Medicine, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Int J Obes (Lond). 2010 Aug;34(8):1255-64. doi: 10.1038/ijo.2010.40. Epub 2010 Feb 23.
We aimed at evaluating whether the addition of low-dose metformin to dietary treatment could be an effective approach in nondiabetic patients with nonalcoholic fatty liver disease (NAFLD).
We carried out a 6-month prospective study in a series of overweight or obese patients with ultrasonographic diagnosis of hepatic steatosis. In total, 50 patients were enrolled and randomized into two groups: the first group (n=25) was given metformin (1 g per day) plus dietary treatment and the second group (n=25) was given dietary treatment alone.
At the end of the study, the proportion of patients with echographic evidence of fatty liver was reduced in both the metformin (P<0.0001) and the diet group (P=0.029). Moreover, patient body mass index and waist circumference significantly decreased in both groups (P<0.001). Fasting glucose, insulin resistance (evaluated as homeostasis model assessment of insulin resistance (HOMA-IR)) and serum adiponectin decreased in both groups, although these changes reached statistical significance only in the metformin group. In this group, HOMA-IR decreased from 3.3+/-1.6 to 2.4+/-1.2 (P=0.003), whereas it decreased from 3.2+/-1.6 to 2.8+/-1.1 (not significant, NS) in the diet group. Similarly, the proportion of patients with impaired fasting glucose declined from 35 to 5% (P=0.04) in the metformin and from 32 to 12% (NS) in the diet group. At baseline, approximately 40% of patients in both groups met the diagnostic criteria of metabolic syndrome. This proportion decreased to 20% in the metformin group (P=0.008) and to 32% in the diet group (NS).
In our 6-month prospective study, both low-dose metformin and dietary treatment alone ameliorated liver steatosis and metabolic derangements in patients with NAFLD. However, metformin was more effective than dietary treatment alone in normalizing several metabolic parameters in these patients.
评估在非糖尿病非酒精性脂肪性肝病（NAFLD）患者中，低剂量二甲双胍联合饮食治疗是否是一种有效的方法。
我们进行了一项为期 6 个月的前瞻性研究，纳入了超声诊断为肝脂肪变性的超重或肥胖患者。共有 50 名患者入组并随机分为两组：第一组（n=25）给予二甲双胍（每天 1 克）加饮食治疗，第二组（n=25）给予单纯饮食治疗。
研究结束时，两组患者的超声脂肪肝证据比例均降低（二甲双胍组：P<0.0001；饮食组：P=0.029）。此外，两组患者的体重指数和腰围均显著降低（P<0.001）。两组患者的空腹血糖、胰岛素抵抗（用稳态模型评估的胰岛素抵抗（HOMA-IR）评估）和血清脂联素均降低，尽管这些变化仅在二甲双胍组具有统计学意义。在该组中，HOMA-IR 从 3.3+/-1.6 降至 2.4+/-1.2（P=0.003），而饮食组从 3.2+/-1.6 降至 2.8+/-1.1（无统计学意义，NS）。同样，空腹血糖受损患者的比例从二甲双胍组的 35%降至 5%（P=0.04），从饮食组的 32%降至 12%（NS）。基线时，两组约 40%的患者符合代谢综合征的诊断标准。该比例在二甲双胍组降至 20%（P=0.008），在饮食组降至 32%（NS）。
在我们的 6 个月前瞻性研究中，低剂量二甲双胍和单纯饮食治疗均改善了 NAFLD 患者的肝脂肪变性和代谢紊乱。然而，与单纯饮食治疗相比，二甲双胍在使这些患者的多项代谢参数正常化方面更有效。
