Effects of metformin on hepatic inflammation, liver fibrosis and insulin resistance in patients with type 2 diabetes mellitus complicated with nonalcoholic fatty liver disease

doi:10.3969/j.issn.1002-7386.2018.12.002

Abstract：Objective To investigate the effects of metformin on hepatic inflammation, liver fibrosis and insulin resistance in patients with type 2 diabetes mellitus ( T2DM) complicated by nonalcoholic fatty liver disease ( NAFLD). Methods A total of 70 patients with T2DM complicated by NAFLG who were admitted and treated in our hospital from June 2011 to May 2016 were divided into observation group ( n =35 ) and control group ( n =35 ) according to random number table. The patients in control group were treated by diet and exercise only,however,the patients in observation group,on the basis of control group,were treated by oral metformin. After 12-week treatment, the levels of tumor necrosis factor-α( TNF-α), interleukin 6 (IL-6), high sensitivity C reactive protein (hs-CRP), triglyceride (TG), total cholesterol (TC), high density lipoprotein ( HDL-C ) , low density lipoprotein ( LDL-C ) , alanine transferase ( ALT ) , aspartate aminotransferase (AST), type Ⅲ procollagen (PCⅢ), type Ⅳ collagen (Ⅳ-C), hyaluronic acid (HA), laminin (LN), fasting plasma glucose (FPG), 2h postprandial blood sugar glucose (2 hPG), glycosylated hemoglobin (HbA1c), fasting insulin (Fins), insulin resistance index ( HOMA-IR ) and incidence of adverse reactions before and after treatment were observed and compared between the two groups. Results After treatment, the indexes of serum inflammatory factors ( TNF-α, IL-6, hs-CRP) , indexes of blood lipid and liver function ( TC, TG, LDL-C, ALT, AST) , indexes of liver fibrosis ( PCⅢ,Ⅳ-C, LN, HA) and indexes of blood glucose and insulin (FPG, 2 hPG, Fins, HbA1c and HOMA-IR) were significantly decreased in both groups, as compared with those before treatment (P<0. 05). Moreover these indexes mentioned above in observation group were significantly lower than those in control group (P<0. 05), however the levels of HDL C in observation group were significantly higher than those in control group (P<0. 05). In addition there was no significant difference in incidence rate of adverse reactions during treatment between two groups (P>0. 05). Conclusion Metformin can significantly improve hepatic inflammatory reactions of patients with T2DM complicated by NAFLD, relieve liver fibrosis, reduce insulin resistance of body, which is conducive to control blood glucose smoothly, without increasing adverse reactions of patients.