Title:Effects of Metformin-Single Therapy on the Level of Inflammatory Markers
in Serum of Non-Obese T2DM Patients with NAFLD
Volume: 22
Issue: 1
Author(s): Bojan Mitrovic, Zoran Gluvic*, Djuro Macut, Milan Obradovic, Emina Sudar-Milovanovic, Sanja Soskic, Dragan Stajic and Esma R. Isenovic
Affiliation:
- Department of Endocrinology and Diabetes, Zemun Clinical Hospital, Faculty of Medicine, University of Belgrade,
Belgrade, Serbia
Keywords:
Diabetes, metformin, non-alcoholic fatty liver disease, inflammation, liver ultrasound, FLI/FIB-4 scores.
Abstract: Background and Objectives: Non-alcoholic fatty liver disease (NAFLD) is associated
with inflammation and subsequent increase in cardiovascular risk. Because of its widespread presence
and distribution, invasive diagnostic procedures (i.e., liver biopsy) are reserved for a limited
number of subjects. With liver ultrasound, Fatty liver index (FLI) and fibrosis-4 (FIB-4) scores
non-invasively assess liver steatosis and fibrosis. We aimed to evaluate the changes in inflammatory
markers and FLI/FIB-4 scores in non-obese metformin-treated type 2 diabetes patients (T2DM)
with NAFLD.
Methods: All subjects underwent abdominal ultrasound aiming for NAFLD stratification (grade 1
to 3 according to its severity). Metabolic parameters (morning glycaemia, HbA1C, lipids, liver
function tests), serum inflammatory markers (C-reactive protein, ferritin, and nitric oxide) and FLI/-
FIB-4 were calculated.
Results: FLI score and ultrasound NAFLD grades were found to correlate (p<0.05). We observed a
significant correlation between the levels of ferritin and C-reactive protein (CRP) (p<0.05), and the
FLI (p<0.05). Body weight (BW) (p<0.05), waist circumference (WC) (p<0.05), the levels of
HbA1c (p<0.05), transferrin (p<0.05), insulin (p<0.05), and FLI score (p<0.05) significantly differed
between groups as defined by the severity of NAFLD.
Conclusion: This pilot study suggests that the serum inflammatory markers at the average normal
values point to the sufficiency of metformin-single therapy in inflammation control in non-obese
T2DM patients with NAFLD.
