BackgroundNonalcoholic fatty liver disease (NAFLD) is one of the most common reasons of enzyme increase in liver. In About 10 percent of patients with NAFLD, the disease progresses toward Non Alcoholic Steatohepatitis (NASH) and about one third of them may progress toward cirrhosis, liver dysfunction, and even hepatocellular carcinoma.ObjectivesAccording to high prevalence of NAFLD and the fact that there is no consensus on treatment of this disease, the aim of this study was to assess the effects of metformin, pioglitazone, and silymarin on treatment of NAFLD.Patients and MethodsSixty six patients with NAFLD who were presented in the Endocrinology and Metabolism clinic of Boo’ali Hospital, Qazvin, Iran, were assigned randomly into three groups (n = 22). First group was treated by pioglitazone 15 mg/d, second group by metformin 500 mg/d, and third group by silymarin 140 mg/d. All patients underwent clinical and biochemical evaluations including weight, fasting blood sugar (FBS), lipid profiles, body mass index (BMI), aspartate aminotransferase (AST ), alanine aminotransferase (ALT), and serum insulin levels in pre- and post-intervention after eight-week follow up.ResultsBefore the treatment there was no significant difference between three groups with respect to average age, BMI and gender, FBS, lipid profile, AST, ALT, serum insulin level, and Homeostasis Model Assessment (HOMA) index for insulin resistance. After the intervention, a significant reduction was observed in average amount of FBS, lipid profile, ALT, AST, serum insulin level and HOMA index in three groups (P < 0.01). The most reduction in average FBS, TG, serum insulin level, and HOMA index was observed in pioglitazone group, the most reduction in average amount of cholesterol was seen in metformin group, and the most decrease in average amount of AST and ALT occurred in silymarin group.ConclusionsThese results suggest that all drugs are beneficial in improving biochemical indices in patients with NAFLD. Changes in AST and ALT in silymarin group were demonstrated more than that in other groups and the average difference between changes was significant between silymarin and metformin groups.

This study was performed to investigate the effects of licorice on non-alcoholic fatty liver disease (NAFLD). In this double blind randomized clinical trial, 66 patients were divided into case and control groups. All patients had elevated liver enzymes and had increased liver echogenicity (lipid accumulation) on sonography. The case group was treated with one capsule containing 2 g aqueous licorice root extract per day for 2 months while the control group was treated in the same manner with a placebo. Weight, body mass index (BMI) and liver transaminase levels were measured for each patient before and after the study. In the case group, the mean alanine aminotransferase (ALT) level decreased from 64.09 to 51.27 IU/mL and the aspartate aminotransferase (AST) level decreased from 58.18 to 49.45 IU/mL, which were statistically significant (p < 0.001 and p < 0.001). But in the control group, a drop in the ALT and AST levels was not statistically significant. The BMI difference before and after the study was not statistically significant in both groups. Despite the significant drop in liver enzymes following administration of licorice root extract, it is recommended that further studies that include histological examination are necessary.

Addition of licorice to the triple clarithromycin-based regimen increases H. pylori eradication, especially in the presence of peptic ulcer disease.

BACKGROUND AND AIMS: The relationship between vitamin D-deficiency and pathogenesis of non-alcoholic fatty liver diseases (NAFLD) has been always a controversial subject. The present study is aimed to investigate the effects of vitamin D on the reduction of liver enzymes and, then, compare its effects with those of diet and physical activities individually. PATIENTS AND METHODS: The present double-blinded randomized clinical trial was conducted at …..University of Medical Sciences in 2017. For this purpose, 80 patients with NAFLD and vitamin D-deficiency were randomly divided into two groups, namely intervention and control. Subsequently, the patients in both groups were provided with programs of diets and physical activities. The patients in the intervention group received, in addition to the given treatment, the vitamin at the dosage of (VIT-D/50000 unit) once per week for ten weeks. Afterwards, the data related to the clinical and demographic characteristics of both groups were collected and, then, compared with each other using statistical methods. RESULTS: The applied therapeutic interventions led to a significant reduction in the variables including AST, ALT, total cholesterol, and LDL-C in both groups (p < 0.05). As for the two indices of blood sugar and triglyceride, the control group exhibited significantly less variations (p < 0.05). C O N C L U S I O N: The obtained results showed that the administration of vitamin D had no considerable superiority over the diet and physical activities in terms of reducing the liver enzymes as well as other investigated parameters.

Background and objective: The correlation between the eradication of Helicobacter pylori (HP) and non-alcoholic fatty liver disease (NAFLD) is a controversial one. The aim of this study is to investigate the effect of Helicobacter pylori treatment on liver function tests and lipid profiles and to compare its effects with exercise therapy and diet alone. Method: This was a double-blind randomized clinical trial conducted at Qazvin University of Medical Sciences. One hundred patients with NAFLD having a positive test for urea breath testing were randomly assigned into one of the intervention and comparison groups. The diet and physical activity program were given to two groups of patients for 8 weeks, three sessions per week. In addition to the above therapy, the patients in the intervention group also received HP treatment for 2weeks. The data corresponding to anthropometric and clinical features before and after the intervention were collected in both groups and compared using appropriate statistical methods. Results: After the treatment interventions, the variables of weight, BMI, blood glucose, triglyceride, AST, ALT, total cholesterol, and LDL-C were significantly decreased in both groups (p < .05). In the between-group comparisons, only ALT was significantly lower in the intervention group (HP) (p < .05). Conclusion: Findings of this study showed that the eradication of Helicobacter pylori could significantly improve the ALT index, but it had no additional effect on changes in metabolic indicators. Trial registration: Registration number: IRCT2015042020951N2 Name of trial registry: The study of treatment of Helicobacter pylori in improvement of non-alcoholic fatty liver disease The date of registration: 2015-05-12 Where the full trial protocol can be accessed: https://fa.irct.ir/trial/18489