Comparison the therapeutic effect of Carnitine and Pioglitazone to Pioglitazone and Vitamin E in patients with non-alcoholic fatty liver disease

Abstract

Non-alcoholic fatty liver disease (NAFLD) includes a range of liver conditions that occur due to the accumulation of fat in hepatocytes (> 5%). Without treatment, this condition can lead to fibrosis, liver cirrhosis, and hepatocellular carcinoma. Due to the increasing prevalence of NAFLD, the absence of FDA-approved treatment for this disease, and the need for further studies and research in this field; This study was performed to evaluate the efficacy of concomitant administration of Pioglitazone and Carnitine in comparison with concomitant administration of Pioglitazone and Vitamin E on ultrasound grade and liver enzymes in patients with non-alcoholic fatty liver. Methods: The present study is a randomized clinical trial in which 80 eligible non-alcoholic fatty liver patients referred to the fatty-liver clinic of the Tabriz University of Medical Science were randomly enrolled. The clinical records of these patients were reviewed and the basic information of the patients was recorded. Patients were randomly divided into two intervention groups. One group of patients received 30 mg of pioglitazone and 1000 mg of carnitine and the other group received 30mg of pioglitazone and 800 units of vitamin E for 6 months daily. In each group, blood samples were taken before, 3 months, and 6 months after administering the drug to evaluate liver enzymes, lipid profile, and FBS. In both study groups, ultrasound of the liver was performed at the beginning and at the end of the study to evaluate the grade of fatty liver. Results: A total of 80 patients were included in the study. There was no statistically significant difference between the two groups in terms of sonographic fatty liver grade and laboratory tests before intervension. In pioglitazone and carnitine group, there was not a significant decrease in the degree of fatty liver garde at the end of the study compared to the beginning of the study. (P-value = 0/14); How ever half of the recipients of these drugs had a reduction in the sonographic grade of the fatty liver during the study. Consumption of pioglitazone and vitamin E caused a statistically significant change in the degree of fatty liver on ultrasound during the study (P-value = 0/01). Consumption of pioglitazone and carnitine significantly decreased ALP and TG variables over 6month. Consumption of pioglitazone and vitamin E significantly dectreased ALT and FBS levels