Title:The Effect of Metformin on Aminotransferase Levels, Metabolic Parameters and Body Mass Index in Nonalcoholic Fatty Liver Disease Patients: A Metaanalysis
Volume: 27
Issue: 29
Author(s): Haibo Hu*, Junjie Wang, Xi Li, Lujun Shen, Danhe Shi and Juanjuan Meng
Affiliation:
- Department of Gastroenterology, Changzhi People’s Hospital, Changzhi,China
Keywords:
Metformin, nonalcoholic fatty liver disease, aminotransferase, metabolic syndrome, body mass index, meta-analysis.
Abstract:
Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common reasons for the
increase in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Moreover, liver-
associated death is approximately 10 times higher in patients with NAFLD than in common individuals. In
theory, NAFLD is a kind of metabolic syndrome that manifests in the liver, and insulin resistance plays an important
role in it. Therefore, drugs that improve insulin sensitivity may be effective for NAFLD.
Objective: The aim of this study was to evaluate the effect of metformin treatment on aminotransferase levels,
metabolic parameters and body mass index in NAFLD patients via a meta-analysis of clinical trials.
Methods: A comprehensive search on PubMed, EMBASE, the Web of Science and the Cochrane Central Register
of Controlled Trials was performed for randomized controlled trials (RCTs) on the effect of metformin treatment
on aminotransferase levels, metabolic parameters and body mass index in NAFLD patients. Serum hepatic
enzyme, lipid, glucose and insulin levels, homeostasis model assessment-insulin resistance (HOMA-IR) index
and body mass index (BMI) at different follow-up points exhibited desirable outcomes. The final search
was performed in January, 2021.
Results: In total, 10 RCTs with 459 patients were included. Compared with controls, metformin could effectively
reduce serum fasting glucose and insulin levels and the HOMA-IR index in NAFLD patients at the 6-month
follow-up. In addition, metformin could clearly reduce the serum ALT and HOMA-IR index at the 12-month
follow-up. Although metformin was found to be effective in managing lipid metabolism and controlling BMI in
NAFLD patients compared with that at baseline, the effect was similar to that in controls. In addition, the speed
of metformin treatment seemed to be slower than that of controls.
Conclusion: Compared to the controls, metformin could effectively reduce the serum fasting glucose and insulin
levels and the HOMA-IR index in NAFLD patients at the 6-month follow-up and ALT and the HOMA-IR
index at the 12-month follow-up.
