Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary Syndrome
Objective. Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance (IR), key features of nonalcoholic steatohepatitis (NASH). Cytokeratin 18 fragments (M30) have been established as a serum marker for NASH. The insulin sensitizer metformin improves hepatic IR. This study e...
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Wiley
2015-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2015/254169 |
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| author | Susanne Tan Nils Vollmar Sven Benson Jan-Peter Sowa Lars P. Bechmann Guido Gerken Dagmar Fuhrer Ali Canbay |
| author_facet | Susanne Tan Nils Vollmar Sven Benson Jan-Peter Sowa Lars P. Bechmann Guido Gerken Dagmar Fuhrer Ali Canbay |
| author_sort | Susanne Tan |
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| description | Objective. Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance (IR), key features of nonalcoholic steatohepatitis (NASH). Cytokeratin 18 fragments (M30) have been established as a serum marker for NASH. The insulin sensitizer metformin improves hepatic IR. This study evaluates the influence of MF on serologic NASH (sNASH) in patients with PCOS. Patients and Methods. In 89 patients, metabolic parameters, liver injury indicating fatty liver (LIFL), and M30 were assessed at baseline and after metformin treatment. Patients with initial IR were subdivided into dissolved (PCOS-exIR) and persistent IR (PCOS-PIR) after treatment and compared to an initially insulin sensitive PCOS group (PCOS-C). Results. Improvement of LIFL prevalence could be seen in PCOS-C and PCOS-exIR compared to PCOS-PIR (−19.4, resp., −12.0% versus 7.2%, Chi2 = 29.5, P<0.001) without change in sNASH prevalence. In PCOS-PIR, ALT levels increased significantly accompanied by a nominal, nonsignificant M30 increase. Conclusions. Metformin improves LIFL in subgroups of patients with PCOS without influencing sNASH. This could either indicate a missing effect of metformin on NAFLD or slowed disease progression. Further studies are needed to elucidate NAFLD in the context of PCOS and potential therapeutic options. |
| format | Article |
| id | doaj-art-656ef10b899547cea460145715a3a405 |
| institution | Kabale University |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
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| series | International Journal of Endocrinology |
| spelling | doaj-art-656ef10b899547cea460145715a3a4052025-02-03T01:09:40ZengWileyInternational Journal of Endocrinology1687-83371687-83452015-01-01201510.1155/2015/254169254169Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary SyndromeSusanne Tan0Nils Vollmar1Sven Benson2Jan-Peter Sowa3Lars P. Bechmann4Guido Gerken5Dagmar Fuhrer6Ali Canbay7Department of Endocrinology and Division of Laboratory Research, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyDepartment of Endocrinology and Division of Laboratory Research, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyInstitute of Medical Psychology and Behavioral Immunobiology, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyDepartment of Gastroenterology and Hepatology, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyDepartment of Gastroenterology and Hepatology, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyDepartment of Gastroenterology and Hepatology, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyDepartment of Endocrinology and Division of Laboratory Research, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyDepartment of Gastroenterology and Hepatology, University Hospital, University of Duisburg-Essen, Hufelandstraße 55, 45147 Essen, GermanyObjective. Polycystic ovary syndrome (PCOS) is associated with obesity and insulin resistance (IR), key features of nonalcoholic steatohepatitis (NASH). Cytokeratin 18 fragments (M30) have been established as a serum marker for NASH. The insulin sensitizer metformin improves hepatic IR. This study evaluates the influence of MF on serologic NASH (sNASH) in patients with PCOS. Patients and Methods. In 89 patients, metabolic parameters, liver injury indicating fatty liver (LIFL), and M30 were assessed at baseline and after metformin treatment. Patients with initial IR were subdivided into dissolved (PCOS-exIR) and persistent IR (PCOS-PIR) after treatment and compared to an initially insulin sensitive PCOS group (PCOS-C). Results. Improvement of LIFL prevalence could be seen in PCOS-C and PCOS-exIR compared to PCOS-PIR (−19.4, resp., −12.0% versus 7.2%, Chi2 = 29.5, P<0.001) without change in sNASH prevalence. In PCOS-PIR, ALT levels increased significantly accompanied by a nominal, nonsignificant M30 increase. Conclusions. Metformin improves LIFL in subgroups of patients with PCOS without influencing sNASH. This could either indicate a missing effect of metformin on NAFLD or slowed disease progression. Further studies are needed to elucidate NAFLD in the context of PCOS and potential therapeutic options.http://dx.doi.org/10.1155/2015/254169 |
| spellingShingle | Susanne Tan Nils Vollmar Sven Benson Jan-Peter Sowa Lars P. Bechmann Guido Gerken Dagmar Fuhrer Ali Canbay Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary Syndrome International Journal of Endocrinology |
| title | Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary Syndrome |
| title_full | Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary Syndrome |
| title_fullStr | Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary Syndrome |
| title_full_unstemmed | Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary Syndrome |
| title_short | Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary Syndrome |
| title_sort | liver injury indicating fatty liver but not serologic nash marker improves under metformin treatment in polycystic ovary syndrome |
| url | http://dx.doi.org/10.1155/2015/254169 |
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