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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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Autores principales: Tan, Susanne, Vollmar, Nils, Benson, Sven, Sowa, Jan-Peter, Bechmann, Lars P., Gerken, Guido, Fuhrer, Dagmar, Canbay, Ali
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383456/
https://www.ncbi.nlm.nih.gov/pubmed/25873949
http://dx.doi.org/10.1155/2015/254169
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author Tan, Susanne
Vollmar, Nils
Benson, Sven
Sowa, Jan-Peter
Bechmann, Lars P.
Gerken, Guido
Fuhrer, Dagmar
Canbay, Ali
author_facet Tan, Susanne
Vollmar, Nils
Benson, Sven
Sowa, Jan-Peter
Bechmann, Lars P.
Gerken, Guido
Fuhrer, Dagmar
Canbay, Ali
author_sort Tan, Susanne
collection PubMed
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%, Chi(2) = 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.
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spelling pubmed-43834562015-04-13 Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary Syndrome Tan, Susanne Vollmar, Nils Benson, Sven Sowa, Jan-Peter Bechmann, Lars P. Gerken, Guido Fuhrer, Dagmar Canbay, Ali Int J Endocrinol Clinical Study 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%, Chi(2) = 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. Hindawi Publishing Corporation 2015 2015-03-19 /pmc/articles/PMC4383456/ /pubmed/25873949 http://dx.doi.org/10.1155/2015/254169 Text en Copyright © 2015 Susanne Tan et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Tan, Susanne
Vollmar, Nils
Benson, Sven
Sowa, Jan-Peter
Bechmann, Lars P.
Gerken, Guido
Fuhrer, Dagmar
Canbay, Ali
Liver Injury Indicating Fatty Liver but Not Serologic NASH Marker Improves under Metformin Treatment in Polycystic Ovary Syndrome
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
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383456/
https://www.ncbi.nlm.nih.gov/pubmed/25873949
http://dx.doi.org/10.1155/2015/254169
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