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The benefit of metformin in the treatment of pediatric non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials
This is the first meta-analysis of the available literature about the efficacy of metformin exclusively in pediatric patients with non-alcoholic fatty liver disease (NAFLD). We conducted a systematic literature search through major electronic databases till March 12, 2023, investigating the efficacy...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10640492/ https://www.ncbi.nlm.nih.gov/pubmed/37639015 http://dx.doi.org/10.1007/s00431-023-05169-9 |
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author | Gkiourtzis, Nikolaos Michou, Panagiota Moutafi, Maria Glava, Agni Cheirakis, Konstantinos Christakopoulos, Aristeidis Vouksinou, Eleni Fotoulaki, Maria |
author_facet | Gkiourtzis, Nikolaos Michou, Panagiota Moutafi, Maria Glava, Agni Cheirakis, Konstantinos Christakopoulos, Aristeidis Vouksinou, Eleni Fotoulaki, Maria |
author_sort | Gkiourtzis, Nikolaos |
collection | PubMed |
description | This is the first meta-analysis of the available literature about the efficacy of metformin exclusively in pediatric patients with non-alcoholic fatty liver disease (NAFLD). We conducted a systematic literature search through major electronic databases till March 12, 2023, investigating the efficacy and safety of metformin in pediatric NAFLD. Weighted mean difference (WD) and standard deviation (SD) were used for continuous outcomes. In total, 4 randomized controlled trials (RCTs) with 309 pediatric patients with NAFLD were included in the meta-analysis. Metformin could not reach a statistically significant improvement in alanine aminotransferase (ALT) levels [(ALT: WMD = − 1.55 IU/L, 95% CI: − 5.38 to 2.28, I(2) = 16%, p = 0.43), but had a statistically significant impact (p < 0.05) in insulin and HOMA-IR regulation, triglycerides, and high-density lipoprotein level improvement. Conclusion: According to the data of this meta-analysis, treatment with metformin failed to statistically improve liver enzymes but may be beneficial in the improvement of lipid parameters and insulin metabolism regulation in pediatric patients with NAFLD. As there are not enough available studies in the literature, the influence of metformin on liver ultrasonography or histology in pediatric NAFLD should be further analyzed in future studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-023-05169-9. |
format | Online Article Text |
id | pubmed-10640492 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-106404922023-11-14 The benefit of metformin in the treatment of pediatric non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials Gkiourtzis, Nikolaos Michou, Panagiota Moutafi, Maria Glava, Agni Cheirakis, Konstantinos Christakopoulos, Aristeidis Vouksinou, Eleni Fotoulaki, Maria Eur J Pediatr Review This is the first meta-analysis of the available literature about the efficacy of metformin exclusively in pediatric patients with non-alcoholic fatty liver disease (NAFLD). We conducted a systematic literature search through major electronic databases till March 12, 2023, investigating the efficacy and safety of metformin in pediatric NAFLD. Weighted mean difference (WD) and standard deviation (SD) were used for continuous outcomes. In total, 4 randomized controlled trials (RCTs) with 309 pediatric patients with NAFLD were included in the meta-analysis. Metformin could not reach a statistically significant improvement in alanine aminotransferase (ALT) levels [(ALT: WMD = − 1.55 IU/L, 95% CI: − 5.38 to 2.28, I(2) = 16%, p = 0.43), but had a statistically significant impact (p < 0.05) in insulin and HOMA-IR regulation, triglycerides, and high-density lipoprotein level improvement. Conclusion: According to the data of this meta-analysis, treatment with metformin failed to statistically improve liver enzymes but may be beneficial in the improvement of lipid parameters and insulin metabolism regulation in pediatric patients with NAFLD. As there are not enough available studies in the literature, the influence of metformin on liver ultrasonography or histology in pediatric NAFLD should be further analyzed in future studies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00431-023-05169-9. Springer Berlin Heidelberg 2023-08-28 2023 /pmc/articles/PMC10640492/ /pubmed/37639015 http://dx.doi.org/10.1007/s00431-023-05169-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Review Gkiourtzis, Nikolaos Michou, Panagiota Moutafi, Maria Glava, Agni Cheirakis, Konstantinos Christakopoulos, Aristeidis Vouksinou, Eleni Fotoulaki, Maria The benefit of metformin in the treatment of pediatric non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials |
title | The benefit of metformin in the treatment of pediatric non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials |
title_full | The benefit of metformin in the treatment of pediatric non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials |
title_fullStr | The benefit of metformin in the treatment of pediatric non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials |
title_full_unstemmed | The benefit of metformin in the treatment of pediatric non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials |
title_short | The benefit of metformin in the treatment of pediatric non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials |
title_sort | benefit of metformin in the treatment of pediatric non-alcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trials |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10640492/ https://www.ncbi.nlm.nih.gov/pubmed/37639015 http://dx.doi.org/10.1007/s00431-023-05169-9 |
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