Abstract :
Background: Insulin resistance and metabolic syndrome is strongly associated with non-alcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH). According to the pathogenesis of NASH, medications that minimize oxidative stress may prove useful. N-acetylcysteine (NAC) is one of glutathione prodrugs which could limit the production of reactive oxygen species. This study aims to investigate the effect of NAC on liver biochemical improvement in metabolic syndrome patients with persistent aminotransferase level elevation.
Methods: Fourteen patients were diagnosed with metabolic syndrome and had persistent alanine aminotransferase (ALT) level over 1.5 times the upper limit of the normal value more than 6 months, after two-month of lifestyle modification, patients were randomized into 2 groups. The first group received NAC of 600 mg orally per day plus the standard treatment for NASH (NAC group) and the second group received only the standard treatment of NASH (control group) for 8 weeks. Changes in variables were measured from baseline to the end of treatment including; serum ALT, AST, fasting serum glucose, triglyceride, low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), and body mass index (BMI).
Results: The baseline characteristics between two groups were similar. At the end of the 8-week treatment period, there was a significant change in the mean ALT and AST levels in the control group (p = 0.03 and 0.04) but not in the treatment group (p = 0.27 and 0.53), respectively. All of the patients tolerated the drug well, without any serious adverse effects.
Conclusion: NAC is a safe medication and can be tolerated well in patients with NAFLD, however, our study could not detect any statistically significant improvement in the level of serum aminotransferase. |
file/Thai-Journal-of-gastroenterology-vol-11-no-3-3809470.pdf