Effects of combined low-dose spironolactone plus vitamin E vs vitamin E monotherapy on insulin resistance, non-invasive indices of steatosis and fibrosis, and adipokine levels in non-alcoholic fatty liver disease: a randomized controlled trial.
Title | Effects of combined low-dose spironolactone plus vitamin E vs vitamin E monotherapy on insulin resistance, non-invasive indices of steatosis and fibrosis, and adipokine levels in non-alcoholic fatty liver disease: a randomized controlled trial. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Polyzos, S. A., Kountouras J., Mantzoros C. S., Polymerou V., & Katsinelos P. |
Journal | Diabetes Obes Metab |
Volume | 19 |
Issue | 12 |
Pagination | 1805-1809 |
Date Published | 2017 12 |
ISSN | 1463-1326 |
Keywords | Adipokines, Adult, Anti-Inflammatory Agents, Non-Steroidal, Biomarkers, Biopsy, Combined Modality Therapy, Dietary Supplements, Female, Humans, Hyperinsulinism, Insulin Resistance, Intention to Treat Analysis, Liver, Liver Cirrhosis, Male, Mineralocorticoid Receptor Antagonists, Non-alcoholic Fatty Liver Disease, Severity of Illness Index, Spironolactone, Ultrasonography, Vitamin E |
Abstract | The beneficial effects of mineralocorticoid receptor blockade by spironolactone have been shown in animal models of non-alcoholic fatty liver disease (NAFLD). The aim of the present 52-week randomized controlled trial was to compare the effects of low-dose spironolactone and vitamin E combination with those of vitamin E monotherapy on insulin resistance, non-invasive indices of hepatic steatosis and fibrosis, liver function tests, circulating adipokines and hormones in patients with histologically confirmed NAFLD. Homeostasis model of assessment of insulin resistance (HOMA-IR) and non-invasive indices of steatosis and fibrosis were calculated. Analysis was intention-to-treat. NAFLD liver fat score, an index of steatosis, decreased significantly in the combination treatment group (P = .028), but not in the vitamin E group, and the difference for group*time interaction was significant (P = .047). Alanine aminotransferase-to-platelet ratio index, an index of fibrosis, did not change. Insulin levels and HOMA-IR decreased significantly only within the combination group (P = .011 and P = .011, respectively). In conclusion, the combined low-dose spironolactone plus vitamin E regimen significantly decreased NAFLD liver fat score. Larger-scale trials are needed to clarify the effect of low-dose spironolactone on hepatic histology. |
DOI | 10.1111/dom.12989 |
Alternate Journal | Diabetes Obes Metab |
PubMed ID | 28452101 |