Jalili Ramin, Somi Mohammad Hossein, Hosseinifard Hossein, Salehnia Fatemeh, Ghojazadeh Morteza, Makhdami Nima, Shirmohammadi Masoud
Department of Internal Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Adv Pharm Bull. 2020 Sep;10(4):542-555. doi: 10.34172/apb.2020.065. Epub 2020 Aug 9.
Non-alcoholic fatty liver disease (NAFLD) and steatohepatitis are two forms of fatty liver disease with benign and malignant nature, respectively. These two conditions can cause an increased risk of liver cirrhosis and hepatocellular carcinoma. Given the importance and high prevalence of NAFLD, it is necessary to investigate the results of different studies in related scope to provide a clarity guarantee of effectiveness. Therefore, this systematic review and meta-analysis aim to study the efficacy of various medications used in the treatment of NAFLD. A systematic search of medical databases identified 1963 articles. After exclusion of duplicated articles and those which did not meet our inclusion criteria, eta-analysis was performed on 84 articles. Serum levels of alanine aminotransferase (ALT), aspartate amino transferase (AST) were set as primary outcomes and body mass index (BMI), hepatic steatosis, and NAFLD activity score (NAS) were determined as secondary outcomes. Based on the P-score of the therapeutic effects on the non-alcoholic steatohepatitis (NASH), we observed the highest efficacy for atorvastatin, tryptophan, orlistat, omega-3 and obeticholic acid for reduction of ALT, AST, BMI, steatosis and NAS respectively. This meta-analysis showed that atorvastatin. life-style modification, weight loss, and BMI reduction had a remarkable effect on NAFLD-patients by decreasing aminotransferases.
非酒精性脂肪性肝病（NAFLD）和脂肪性肝炎是分别具有良性和恶性性质的两种脂肪性肝病形式。这两种情况会增加肝硬化和肝细胞癌的风险。鉴于NAFLD的重要性和高患病率，有必要调查相关范围内不同研究的结果，以确保疗效的清晰度。因此，本系统评价和荟萃分析旨在研究用于治疗NAFLD的各种药物的疗效。对医学数据库进行系统检索后识别出1963篇文章。在排除重复文章和不符合纳入标准的文章后，对84篇文章进行了荟萃分析。将血清丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）水平设定为主要结局，将体重指数（BMI）、肝脂肪变性和NAFLD活动评分（NAS）确定为次要结局。基于对非酒精性脂肪性肝炎（NASH）治疗效果的P值，我们分别观察到阿托伐他汀、色氨酸、奥利司他、ω-3和奥贝胆酸在降低ALT、AST、BMI、脂肪变性和NAS方面具有最高疗效。这项荟萃分析表明，阿托伐他汀、生活方式改变、体重减轻和BMI降低通过降低转氨酶对NAFLD患者有显著影响。
