Retrospective evaluation of the effects of metformine, vitamin d and combined treatments on "fatty liver index" in non-alcoholic fatty liver patients with vitamin d deficiency

Aim: Non-Alcoholic Fatty Liver Disease in contemporary societies is quite often confron-ted. It is aimed at early diagnosis and treatment with simpler methods. There are hypothetical advocates that vitamin D deficiency may play a role in the etiopathogenesis of hepatosteatosis. We aimed to investigate the efficacy of metformin and vitamin D treatment in the treatment of hepatosteatosis. Materials and Methods: Retrospective analysis was performed on patients with nonalcoholic fatty liver disease and accompanying vitamin D deficiency. Patients with NAFLD who were followed up with or without insulin resistance and metobolic sendrom companent's were included in the study. Patients who were considered to have vitamin D deficiency and hepatosteatosis (with appropriate Fatty Liver Index (FLI)), two examinations at intervals of six to ten months and enough data for all of them at HİS included. Patients were treated in 4 groups according to whether they took metformin and vitamin D replacement therapy. Twenty one patients were included in the study in each group. The change between posttreatment and baseline values was assessed. Primer endpoint: Combination of metformin and vitamin D replacement therapy superior to the others, according to change in FLI. Seconder endpoint: Statistical analysis of changes in weight, BMI, waist circumference, HOMA-IR, AST, ALT, GGT, TG. Results: The decrease in hepatosteatosis was statistically significant in patients treated with Metformin + vitamine D (FLI: -%5,85 ± 11,1, p = 0,025). In the group with only metformin treatment, weight, waist circumference and HOMA-IR showed a statistically significant decrease similar to the combined treatment group but the change in Fatty Liver Index was not statistically significant (p = 0.090). This may be a sign that the combination of metformin and vitamin D treatment will have successful results in treating hepatic steatosis. There was a decline in FLI in the group of patients who did not receive any pharmacological treatment but followed only with diet and exercise. It's related to the effect of decrease in GGT, TG, weight, waist circumference which constitute FLI, although decrease in this parameters was not significant. Conclusion: There are dozens of studies that say that vitamin D plays a role in the etiopathogenesis of hepatosteatosis with pleotropic effects. Our work is an example of this. Unlike previous studies, metfromin, vitamin D replacement therapy was observed by the patients, and we found a significant decrease in hepatosteatosis. This effect is absent in patients who is receiving only metformin or only vitamine D. Key words: fatty liver ındex, non alcoholic fatty liver disease, vitamin D deficiency, metformin