Meta-analysis: insulin sensitizers for the treatment of non-alcoholic steatohepatitis
dc.contributor.author | Rakoski, Mina O. | en_US |
dc.contributor.author | Singal, Amit G. | en_US |
dc.contributor.author | Rogers, Mary A. M. | en_US |
dc.contributor.author | Conjeevaram, Hari S. | en_US |
dc.date.accessioned | 2011-01-31T17:45:32Z | |
dc.date.available | 2012-01-03T20:18:47Z | en_US |
dc.date.issued | 2010-11 | en_US |
dc.identifier.citation | Rakoski, M. O.; Singal, A. G.; Rogers, M. A. M.; Conjeevaram, H.; (2010). "Meta-analysis: insulin sensitizers for the treatment of non-alcoholic steatohepatitis." Alimentary Pharmacology & Therapeutics 32(10): 1211-1221. <http://hdl.handle.net/2027.42/79251> | en_US |
dc.identifier.issn | 0269-2813 | en_US |
dc.identifier.issn | 1365-2036 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/79251 | |
dc.description.abstract | Aliment Pharmacol Ther 2010; 32: 1211–1221Non-alcoholic fatty liver disease generally has a benign course; however, patients with non-alcoholic steatohepatitis (NASH) may progress to cirrhosis and hepatocellular carcinoma. Currently, there is a lack of consensus about optimal NASH treatment.To assess the efficacy of insulin-sensitizing agents on histological and biochemical outcomes in randomized control trials of biopsy-proven NASH.Multiple online databases and conference abstracts were searched. Random effects meta-analyses were performed, with assessment for heterogeneity and publication bias.Nine trials were included; five trials using thiazolidinediones (glitazones), three using metformin and one trial using both drugs. There was no publication bias. Compared with controls, glitazones resulted in improved steatosis (WMD = 0.57, 95% CI 0.36–0.77, P = <0.001), hepatocyte ballooning (WMD = 0.36, 95% CI 0.24–0.49, P < 0.001) and ALT (WMD = 16.4, 95% CI 7.7–25.0, P < 0.001), but not inflammation ( P = 0.09) or fibrosis ( P = 0.11). In patients without diabetes, glitazones significantly improved all histological and biochemical outcomes, most importantly including fibrosis (WMD = 0.29, 95% CI 0.078–0.51, P = 0.008). Metformin failed to improve any pooled outcome.Treatment of NASH with glitazones, but not metformin, demonstrates a significant histological and biochemical benefit, especially in patients without diabetes. Additional studies are needed to investigate long-term outcomes of glitazone therapy in patients without diabetes. | en_US |
dc.format.extent | 261073 bytes | |
dc.format.extent | 3106 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Blackwell Publishing Ltd | en_US |
dc.title | Meta-analysis: insulin sensitizers for the treatment of non-alcoholic steatohepatitis | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Otolaryngology | en_US |
dc.subject.hlbsecondlevel | Pharmacy and Pharmacology | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Internal Medicine, Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI, USA. | en_US |
dc.contributor.affiliationum | Division of General Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA. | en_US |
dc.identifier.pmid | 20955440 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/79251/1/j.1365-2036.2010.04467.x.pdf | |
dc.identifier.doi | 10.1111/j.1365-2036.2010.04467.x | en_US |
dc.identifier.source | Alimentary Pharmacology & Therapeutics | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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