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- Title
Effects of combined low-dose spironolactone plus vitamin E vs vitamin E monotherapy on insulin resistance, non-invasive indices of steatosis and fibrosis, and adipokine levels in non-alcoholic fatty liver disease: a randomized controlled trial.
- Authors
Polyzos, Stergios A.; Kountouras, Jannis; Mantzoros, Christos S.; Polymerou, Vaia; Katsinelos, Panagiotis
- Abstract
The beneficial effects of mineralocorticoid receptor blockade by spironolactone have been shown in animal models of non-alcoholic fatty liver disease ( NAFLD). The aim of the present 52-week randomized controlled trial was to compare the effects of low-dose spironolactone and vitamin E combination with those of vitamin E monotherapy on insulin resistance, non-invasive indices of hepatic steatosis and fibrosis, liver function tests, circulating adipokines and hormones in patients with histologically confirmed NAFLD. Homeostasis model of assessment of insulin resistance ( HOMA-IR) and non-invasive indices of steatosis and fibrosis were calculated. Analysis was intention-to-treat. NAFLD liver fat score, an index of steatosis, decreased significantly in the combination treatment group ( P = .028), but not in the vitamin E group, and the difference for group*time interaction was significant ( P = .047). Alanine aminotransferase-to-platelet ratio index, an index of fibrosis, did not change. Insulin levels and HOMA-IR decreased significantly only within the combination group ( P = .011 and P = .011, respectively). In conclusion, the combined low-dose spironolactone plus vitamin E regimen significantly decreased NAFLD liver fat score. Larger-scale trials are needed to clarify the effect of low-dose spironolactone on hepatic histology.
- Subjects
FATTY liver; THERAPEUTICS; SPIRONOLACTONE; THERAPEUTIC use of vitamin E; INSULIN resistance; FATTY degeneration; FIBROSIS; ADIPOKINES; MINERALOCORTICOID receptors
- Publication
Diabetes, Obesity & Metabolism, 2017, Vol 19, Issue 12, p1805
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/dom.12989