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Hajiagha Mohammadi A A, Khajeh Jahromi S, Ahmadi Gooraji S, Bastani A. Comparison of the Therapeutic Effects of Melatonin, Metformin and Vitamin E on Non-Alcoholic Fatty Liver Disease: A Randomized Clinical Trial. J Adv Med Biomed Res 2022; 30 (140) :232-240
URL: http://journal.zums.ac.ir/article-1-6407-en.html
Comparison of the Therapeutic Effects of Melatonin, Metformin and Vitamin E on Non-Alcoholic Fatty Liver Disease: A Randomized Clinical Trial
Ali Akbar Hajiagha Mohammadi1 , Sina Khajeh Jahromi *2 , Somayeh Ahmadi Gooraji3 , Ali Bastani1
1- Metabolic Diseases Research Center, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
2- Metabolic Diseases Research Center, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran , sina.khajehjahromi@gmail.com
3- Dept. of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract:   (83714 Views)

Background and Objective: Currently, no therapeutic or surgical treatment for non-alcoholic fatty liver disease (NAFLD) has been officially approved. This is a serious void in the medical field given the increasing prevalence of NAFLD cases in developing countries. Our study compared the therapeutic effect of metformin, melatonin and vitamin E on serum parameters that are associated with NAFLD pathogenesis.
Materials and Methods: This randomized clinical trial was performed on 140 patients with NAFLD who were referred to the central hospital of Qazvin. Patients were assigned randomly into four groups. The first group received metformin (500mg daily) with two placebos, the second group received melatonin (10mg daily) with two placebos, the third group received daily 800 IU vitamin E with two placebos and the fourth group received three placebos daily. All four groups were placed on the same diet regimen and had the same lifestyle changes to increase their daily activity time. Ultrasonography was used for the evaluation of the appearance of liver. Weight, BMI, AST, ALT, lipid profile and FBS were measured at baseline, 3 months and 6 months later.
Results: All of the therapeutic agents caused a decrease in aminotransferases but metformin was also more potent in improving lipid profiles. A significant difference in LDL was obtained by melatonin (mean change in the control vs. melatonin 15.9; P=0.032) and AST (mean change in control vs. melatonin -18.3; P<0.001). Metformin improved liver appearance in ultrasonography imaging better than the other treatments (P=0.043).
Conclusion: Metformin can be considered an effective medication but melatonin may accelerate the healing process in NAFLD patients.

Keywords: Non-alcoholic Fatty Liver Disease, Melatonin, Metformin, Vitamin E.
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✅ Metformin can be considered an effective medication but melatonin may accelerate the healing process in NAFLD patients.


Type of Study: Clinical Trials | Subject: Clinical Medicine
Received: 2021/01/28 | Accepted: 2021/06/24 | Published: 2022/04/1
References
1. Tahan V, Atug O, Akin H, et al. Melatonin ameliorates methionine- and choline-deficient diet-induced nonalcoholic steatohepatitis in rats. J Pineal Res. 2009;46(4):401-7. [DOI:10.1111/j.1600-079X.2009.00676.x] [PMID]
2. Preiss D, Sattar N. Non-alcoholic fatty liver disease: an overview of prevalence, diagnosis, pathogenesis and treatment considerations. Clin Sci (Lond). 2008;115(5):141-50. [DOI:10.1042/CS20070402] [PMID]
3. Mazza A, Fruci B, Garinis GA, Giuliano S, Malaguarnera R, Belfiore A. The role of metformin in the management of NAFLD. Exp Diabetes Res. 2012;2012:716404. [DOI:10.1155/2012/716404] [PMID] [PMCID]
4. Sanyal AJ, Chalasani N, Kowdley KV, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. New Eng J Med. 2010;362(18):1675-85. [DOI:10.1056/NEJMoa0907929] [PMID] [PMCID]
5. Aksakal O, Yilmaz B, Gungor T, et al. A randomised controlled trial on melatonin and rosiglitazone for prevention of adhesion formation in a rat uterine horn model. Arch Gynecol Obstet. 2010;282(1):55-61. [DOI:10.1007/s00404-009-1240-8] [PMID]
6. Mohammadghasemi F, Jahromi SK. Melatonin ameliorates testicular damages induced by nicotine in mice. Iran J Basic Med Sci. 2018;21(6):639-44.
7. Mohammadghasemi F, Jahromi SK, Hajizadeh H, Homafar MA, Saadat N. The protective effects of exogenous melatonin on nicotine-induced changes in mouse ovarian follicles. J Reprod Infertil. 2012;13(3):143-50.
8. Saadat SN, Mohammadghasemi F, Jahromi SK, Homafar MA, Haghiri M. Melatonin protects uterus and oviduct exposed to nicotine in mice. Interdiscip Toxicol. 2014;7(1):41-6. [DOI:10.2478/intox-2014-0007] [PMID] [PMCID]
9. Karamitri A, Jockers R. Melatonin in type 2 diabetes mellitus and obesity. Nat Rev Endocrinol. 2019;15(2):105-25. [DOI:10.1038/s41574-018-0130-1] [PMID]
10. Nishida S, Segawa T, Murai I, Nakagawa S. Long-term melatonin administration reduces hyperinsulinemia and improves the altered fatty-acid compositions in type 2 diabetic rats via the restoration of Delta-5 desaturase activity. J Pineal Res. 2002;32(1):26-33. [DOI:10.1034/j.1600-079x.2002.10797.x] [PMID]
11. Sun H, Wang X, Chen J, et al. Melatonin treatment improves insulin resistance and pigmentation in obese patients with Acanthosis nigricans. Int J Endocrinol. 2018;2018:2304746. [DOI:10.1155/2018/2304746] [PMID] [PMCID]
12. Mota M, Banini BA, Cazanave SC, Sanyal AJ. Molecular mechanisms of lipotoxicity and glucotoxicity in nonalcoholic fatty liver disease. Metabolism. 2016;65(8):1049-61. [DOI:10.1016/j.metabol.2016.02.014] [PMID] [PMCID]
13. Sun H, Wang X, Chen J, et al. Melatonin improves non-alcoholic fatty liver disease via MAPK-JNK/P38 signaling in high-fat-diet-induced obese mice. Lipids Health Dis. 2016;15(1):202. [DOI:10.1186/s12944-016-0370-9] [PMID] [PMCID]
14. Li Y, Liu L, Wang B, Wang J, Chen D. Metformin in non-alcoholic fatty liver disease: A systematic review and meta-analysis. Biomed Rep. 2013;1(1):57-64. https://doi.org/10.3892/br.2012.18 [DOI:10.3892/br.2013.186] [PMID] [PMCID]
15. Haukeland JW, Konopski Z, Eggesbo HB, et al. Metformin in patients with non-alcoholic fatty liver disease: a randomized, controlled trial. Scand J Gastroenterol. 2009;44(7):853-60. [DOI:10.1080/00365520902845268] [PMID]
16. Lavine JE. Vitamin E treatment of nonalcoholic steatohepatitis in children: a pilot study. J Pediatr. 2000;136(6):734-8. https://doi.org/10.1067/mpd.2000.106566 [DOI:10.1016/S0022-3476(00)05040-X] [PMID]
17. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. JAMA. 2007;297(8):842-57. [DOI:10.1001/jama.297.8.842] [PMID]
18. Klein EA, Thompson IM, Tangen CM, et al. Vitamin E and the risk of prostate cancer: the selenium and vitamin E cancer prevention trial (SELECT). JAMA. 2011;306(14):1549-56. [DOI:10.1001/jama.2011.1437] [PMID] [PMCID]
19. Schurks M, Glynn RJ, Rist PM, Tzourio C, Kurth T. Effects of vitamin E on stroke subtypes: meta-analysis of randomised controlled trials. BMJ. 2010;341:c5702. [DOI:10.1136/bmj.c5702] [PMID] [PMCID]
20. Gonciarz M, Gonciarz Z, Bielanski W, et al. The pilot study of 3-month course of melatonin treatment of patients with nonalcoholic steatohepatitis: effect on plasma levels of liver enzymes, lipids and melatonin. J Physiol Pharmacol. 2010;61(6):705-10.
21. Gonciarz M, Gonciarz Z, Bielanski W, et al. The effects of long-term melatonin treatment on plasma liver enzymes levels and plasma concentrations of lipids and melatonin in patients with nonalcoholic steatohepatitis: a pilot study. J Physiol Pharmacol. 2012;63(1):35-40.
22. Celinski K, Konturek PC, Slomka M, et al. Effects of treatment with melatonin and tryptophan on liver enzymes, parameters of fat metabolism and plasma levels of cytokines in patients with non-alcoholic fatty liver disease--14 months follow up. J Physiol Pharmacol. 2014;65(1):75-82.
23. Hannah WN, Harrison SA. Effect of weight loss, diet, exercise, and bariatric surgery on nonalcoholic fatty liver disease. Clin Liver Dis. 2016;20(2):339-50. [DOI:10.1016/j.cld.2015.10.008] [PMID]
24. Hsu CC, Ness E, Kowdley KV. Nutritional approaches to achieve weight loss in nonalcoholic fatty liver disease. Adv Nutr. 2017;8(2):253-65. [DOI:10.3945/an.116.013730] [PMID] [PMCID]
25. Romero-Gomez M, Zelber-Sagi S, Trenell M. Treatment of NAFLD with diet, physical activity and exercise. J Hepatol. 2017;67(4):829-46. [DOI:10.1016/j.jhep.2017.05.016] [PMID]
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