comparison of ezetimibe and acarbose in decreasing liver transaminase in nonalcoholic fatty liver disease: a randomized clinical trial

ABSTRACT

Ezetimibe inhibits the resorption of dietary and biliary cholesterol in the small intestine and decreases insulin resistance in patients with nonalcoholic fatty liver disease [NAFLD]. Acarbose has been used in type 2 diabetes mellitus and metabolic syndrome. This study aims to compare the therapeutic effects of ezetimibe and acarbosein decreasing liver transaminase levels in patients with NAFLD. This was a single center, double-blind, parallel-group study conducted at Bu-Ali Sina Hospital, Qazvin, Iran. In this trial, we enrolled, by simple randomization, a total of 62 patients diagnosed with NASH. There were 29 patients treated with ezetimibe and 33 who were treated with acarbose over a ten-week period. Ezetimibe treatment significantly reduced ALT, AST, triglycerides, total cholesterol, low-density lipoprotein [LDL] cholesterol, high-sensitivity C-reactive protein [hsCRP], and serum insulin levels and the insulin resistance homeostasis model assessment [HOMA-IR] index compared to patients treated with acarbose [p<0.001]. Ezetimibe treatment decreased ALT [p=0.05], AST [p=0.01], total cholesterol [p=0.01], HDL cholesterol [p=0.03] and LDL cholesterol [p=0.03] levels to a significantly higher extent. Both ezetimibe and acarbose improved metabolic and biochemical abnormalities in patients with NASH, however these effects were more prominent with ezetimibe