Metformin in non-alcoholic steatohepatitis

There is no established treatment for steatohepatitis in patients who are n ot alcoholics. This disease is a potentially progressive liver disease asso ciated with hepatic insulin resistance. Only a weight-reducing diet In over weight patients has proved effective. We treated 20 patients who had steato hepatitis but were not alcoholics with metformin (500 mg three times a day for 4 months), an agent that improves hepatic insulin sensitivity. When com pared with the six Individuals not complying with treatment, long-term metf ormin significantly reduced mean transaminase concentrations, which returne d to normal in 50% of actively-treated patients. Also, Insulin sensitivity improved significantly and liver volume decreased by 20%. Similar data have been reported In insulin-resistant ob/ob mice with fatty liver. A randomis ed-controlled study is needed.