Endocrine Abstracts

Introduction: Obesity is a global public health problem and is associated with metabolic syndrome and dyslipidemia as well as very often with non-alcoholic steatohepatitis (NASH).

Aim & methods: The aim of the present study was to evaluate the preventive and curable role of vitamin E and pioglitazone (thiazolidinedione-type) in NASH patients with or without metabolic syndrome. 51 patients with NASH were divided into two groups: 26 patients with insulin-resistance (IR) plus obesity and 24 patients without IR. 12 patients from 1-st group (another 14 patients from this group served as a control subgroup) and 12 patients from 2-nd group were treated at least during 3 months with vitamin E (500–1000 mg daily) plus pioglitazone 15–30 mg/d (another 13 patients – control subgroup) as well as put on the low-fat diet. Gender distribution of the patients was equal in each subgroup (26 male, 25-female). Mean age was 46.6±6.4 years. Mean BMI (body mass index) - 34.6±4.1 kg/m². HOMA-IR of patients from 1-st group was 2.7±0.8.

Results: The concentration of the serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) levels (P<0.01) as well as cholesterol and triglycerides (P<0.05) were found to be higher in the both subgroups without pointed treatment. HDL level, however, was comparable in both groups (P>0.05). Results also indicated that this therapy reduced BMI (P<0.05) and HOMA-index (P<0.05) in both subgroups.

Conclusions: Insulin resistance appears to be the underlying pathophysiological defect leading to NASH. The data from this study demonstrate the possible mechanism by which pioglitazone and vitamin E mediate their beneficial clinical and metabolic effects in patients with NASH. To prevent this condition is to maintain a healthy diet and rigorous exercise regimen.