FEATURES OF THERAPY OF PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE, INSULIN RESISTANCE AND INCREASED LEPTIN LEVELS
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i3.14003Keywords:
non-alcoholic fatty liver disease, resistance insulin steatosis, leptin, metforminAbstract
SUMMARY. Non-alcoholic fatty liver disease is one of the most common liver diseases of non-alcoholic origin. The etiological factors responsible for the development and progression of this disease are numerous and not yet fully understood. One of these factors is the elevated level of leptin. This article presents the primary results of treating patients with non-alcoholic fatty liver disease and elevated leptin levels using metformin.
The aim – to investigate the effect of metformin on the severity of steatosis in patients with non-alcoholic fatty liver disease, insulin resistance and elevated leptin levels.
Material and Methods. The reseach included 25 patients (13 females and 12 males) aged between 35 and 60 years, who were divided into two treatment groups. All patients had signs of steatosis in non-alcoholic fatty liver disease, insulin resistance and elevated leptin levels. The inclusion criteria were clinical, instrumental, and laboratory manifestations of steatosis and non-alcoholic fatty liver disease (including the results of validated tests for detecting fibrosis in non-alcoholic fatty liver disease – Fib-4, NAFLD Fibrometer), insulin resistance (anthropometric data, НOMA index, glucose level ) and elevated leptin levels in the blood, the absence of alcohol or diabetes history. The calculation was performed three months after the start of therapy to monitor changes.
Results. The analysis of subjective complaints, laboratory, and instrumental findings showed that the treatment in both groups had a positive trend. It is worth noting that the indicators in group 2, which received metformin, showed a rapid tendency to improve. This is particularly true for glucose levels and leptin levels in the blood. Significant correlation changes were also observed in the patients' self-feeling, complaints, and ultrasound and elastography control checks, namely, a decrease in liver size and echogenicity. It is worth noting the complaints about thirst, which showed opposite results after treatment – this complaint was more often reduced in patients who did not receive metformin. This can be explained by the pharmacokinetics and the action of the drug during the first months of treatment.
Conclusions. The results of the study suggest a correlation between metformin, leptin, and NAFLD, as we observe a positive trend in indicators after a month of metformin use, even compared to the group where metformin was not included in the treatment. These data make it possible to assert that the treatment is effective and observation and control should continue at 6 months, and 1 year from the beginning of treatment.
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