Melatonin in correction of the antioxidant status in patients with non-alcoholic steatohepatitis concomitant with type 2 diabetes mellitus

Abstract

The purpose of the present work was the assessment of clinical efficiency of therapy including melatonin in patients with non-alcoholic steatohepatitis and concomitant type 2 diabetes mellitus. The study included 59 patients divided into two groups. The first group of 33 patients received basic treatment, the second group of 25 patients was given melatonin in addition to basic therapy. During the study the analysis of dynamics of clinical symptoms was carried out, the state of a free radical homeostasiswas evaluated by biochemiluminescense, and activity of enzymatic components of the antioxidant system (catalase and superoxide dismutase (SOD)) measured to compare effects of basic treatment and its combination with melatonin. Patients with non-alcoholic steatohepatitis showed the increase of gamma-glutamyl transpeptidase activity that reflected hepatic dysfunction, intensification of free radical oxidation processes, an imbalance the antioxidant system, namely decrease of the SOD activity and increase of the catalase activity. The combined treatment with melatonin produced more significant clinical effect in comparison with basic therapy as confirmed by changes in the clinical picture of the disease. At the same time, a greater decrease of the gamma-glutamyl transpeptidase activity, biochemiluminescent indicators, changes of SOD and catalase activities under effect of combined therapy with melatonin than in the patients given basic treatment was apparent. These findings can be attributed to melatonin antioxidant effect responsible for inhibition of free radical oxidation, reduction of the severity of imbalance in the function of antioxidant enzymes and suppression of the inflammatory process in the liver.