The effects of proton pump inhibitors for dispeptic complaints in patients with nonalcoholic steatohepatitis

Abstract

As the most common liver disease in recent years, nonalcoholic fatty liver disease (NAFLD) has gained great importance. In recent years, a close relationship with insulin resistance has been shown in the pathogenesis of NAFLD and its severe form, NASH. This study aimed to observe the effects of proton pump inhibitors (PPIs) on insulin resistance and hepatosteatosis by causing hypergastrinemia. Forty-two patients diagnosed with steatohepatitis were included in the study. Seventeen of the 42 patients were followed up with dietary therapy alone, and 25 were followed up with diet+PPI for 2 months due to accompanying dyspeptic complaints. Biochemical and anthropometric measurements of the patients were made before and after the treatment. Levels of the following parameters decreased significantly after treatment in ca ses followed only with diet: total cholesterol (p=0.009), low-density lipoprotein (LDL) (p=0.007), weight (p=0.004), waist circumference (p=0.006), and body mass index (BMI) (p=0.026). Whereas, there was a significant decrease in the levels of alanine tran saminase (ALT) (p=0.005), aspartate transaminase (AST) (p=0.009), total cholesterol (p=0.020), low-density lipoprotein (LDL) (p=0.031), and waist circumference (p=0.008) after treatment with diet+PPI. After two months, the increase in the mean insulin resistance levels (HOMA-IR) in the diet group was significantly higher than the increase of mean HOMA-IR levels in the diet+PPI group (p=0.02). In conclusion, a significant improvement in liver enzymes was observed in patients with Nonalcoholic steatohepatitis with 2 months of pantoprazole treatment added to dietary management.