Meta-analysis Of Metformin For The Management Of Non-alcoholic Fatty Liver Disease

Objective To systematically evaluate the effectiveness of metforminfor the management of nonalcoholic fatty liver disease(NAFLD).Methods The Cochrane Library, PubMed, EMbase and CNKI databases were searched to identify randomized controlled trials (RCT)published before June2012that compared the effectiveness of metforminand placebo for the management of nonalcoholic fatty liver disease.Meta-analysis was performed using the software RevMan5.1.Results The meta-analysis revealed that, compared with controls,metformin significantly reduced the level of fasting plasma glucose,hemoglobin A1c(HbA1c), total cholesterol and low-densitylipoprotein(LDL) cholesterol, increased the level of high-densitylipoprotein(HDL) cholesterol, decreased the body weight, improved thehomeostasis model assessment for insulin resistance(HOMA-IR), there wasstatistically significant between the two groups. The weighted meandifferenc（eWMD）and95%confidence interval(95%CI) were-0.23（-0.42,-0.06, P=0.02）,-0.34（-0.62,-0.06, P=0.02）,-0.37（-0.64,0.10, P＝0.007）, -0.46（-0.91,0.01, P＝0.0002）,-0.08（-0.00，0.16, P＝0.05）,-4.41（-6.28,-2.54, P＜0.00001）,-0.71（-1.10,-0.32, P＝0.0003）,respectively. Inaddition, metformin also reduced the level of alanine Aminotransferase（ALT） and aspartate aminotransferase（AST）,decreased BMI andTriglycerides, but there was no difference between the two groups. WMDand95%CI were-6.39（-16.13,3.36,P＝0.20）,-4.26（-11.07,2.54, P＝0.22）,-0.47（-1.19,0.26, P＝0.21）,-0.03（-0.25,0.18, P＝0.76）,respectively.Conclusion Metformin can effectively improve blood sugar, bloodlipid levels, insulin resistance and lose weight, it may also improve thepathological changes of the liver tissue, and thus it can be identified as apreferable option for the treatment of nonalcoholic fatty liver disease.