Treatment of Non Alcoholic Fatty Liver Disease 3.3. Statistical Analysis After data collection, findings were formulated as sta- tistical tables and numerical indices. Analyses involving these measures consisted of repeated measures MANOVA using pre- and post-intervention FBS, lipid profiles, Insu- lin, AST, ALT, HOMA index, and BMI in three groups. Prob- ability value less than 0.05 was considered as statistically significant. 4. Results Sixty six subjects completed the study (22 in each study group). We first assessed distribution of variables be- fore using parametric analyses and results showed that all of them were normal. None of patients withdraw from study during research. 14 males (63.4%) and eight females (36.6%) were studied in each of three groups of pioglitazone, metformin, and silymarin. Average ages for pioglitazone, metformin, and silymarin groups were 33.4 ±6.6, 32.5± 6.5 and 33.5± 6.3 years, respectively. Compari- son of characteristics and some parameters of partici- Table 1. Characteristics and Some Parameters of 66 Participants at Base Line Mean ± SD Hajiaghamohammadi AA et al. pants before and after treatment with pioglitazone, met- formin, and silymarin are shown in Table 2. We were also interested in clinical significance of treatment. We used cut off 100 for FBS, 150 for TG, 40 for ALT and AST, 2.5 for HOMA-Index, and 200 for cholesterol (Table 3). Strength of treatment effects in three groups of intervention has been shown is Table 4. 5. Discussion The aim of this study was to assess the effectiveness of silymarin, pioglitazone, and metformin on some bio- chemical markers in NAFLD. In most studies conducted regarding the NAFLD, the influence of drugs effective in treating this disease has been examined in isolation or to- gether with placebo. In this study the effects of drugs re- ducing insulin resistance (metformin and pioglitazone) and an antioxidant drug (silymarin) on improvement of biochemical indices, weight, and body mass index were compared. These three drugs showed beneficial effects on NAFLD treatment and no specific side effects were report- Minimum Maximum 44 96 109 386 275 79 120 24.4 2 32.91 0.001 0.001 0.001 0.001 0.027 0.003 0.005 3 Age, y Weight, kg FBS a, mmol/L TG a, mg/dL CHOL a, mg/dL AST a, IU/L ALT a, IU/L Insulin level, mmol/L HOMA-IR a BMI a, kg/m 2 32.62 ± 6.40 76.95 ± 9.25 95.50 ± 6.58 251.57 ± 53.25 193.45 ± 34.12 55.31 ± 10.49 78.18 ± 19.09 14.18 ± 3.80 2.88 ± 92 27.44 ± 1.69 22 62 85 180 137 39 51 9.3 1 24.61 a Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; CHOL, cholesterol; FBS, fasting blood sugar; HOMA-IR, homeostasis model assessment index for insulin resistance; TG, triglyceride Table 2. Repeated Measures MANOVA in Three Intervention Group (Metformin, Pioglitazone, Silymarin) After two Months Follows Up Pioglitazone, Mean ± SD Metformin, Mean ± SD Silymarin, Mean ± SD F (Time Treatment) P value Weight, kg BMI a, kg/m 2 FBS a, mmol/L TG a, mg/dL AST a, IU/L ALT a, IU/L CHOL a, mg/dL 195.68 ± 34.35 Before 76.95 ± 9.17 27.36 ± 1.65 95.45 ± 6.88 252.18 ± 52.81 55.0 ± 9.49 77.45 ± 18.53 After 77.82 ± 9.32 27.67 ± 1.77 84.91 ± 5.26 Before 76.9 ± 9.52 27.53 ± 1.85 95.09 ± 7.00 After 75.46 ± 9.9 27.00 ± 1.98 87.41 ± 5.28 Before 77.00 ± 9.50 27.44 ± 1.65 95.95 ± 6.11 224.09 ± 47.06 248.36 ± 53.20 222.73 ± 50.39 254.18 ± 56.04 239.09 ± 52.72 178.64 ± 31.95 193.00 ± 35.69 175.86 ± 31.95 191.68 ± 33/81 37.59 ± 8.67 52.27 ± 14.53 54.86 ± 11.29 78.36 ± 19.88 42.5 ± 10.02 60.95 ± 14.21 56 ± 11.07 78.73 ± 19.71 After 77.09 ± 9.52 27.48 ± 1.70 93.95 ± 5.74 181.32 ± 32.44 37.77 ± 8.78 53.05 ± 13.99 46.127 43.93 56.240 9.546 3.818 6.264 5.749 Insulin Levels, 14.20 ± 3.78 11.76 ± 3.26 14.17 ± 3.99 12.06 ± 3.57 14.20 ± 3.82 13.50 ± 3.70 28.12 0.001 mmol/L HOMA-IR a 2.89 ± 0.93 2.12 ± 0.67 2.87 ± 0.98 2.24 ± 0.77 2.9 ± 0.93 2.7 ± 0.85 27.56 0.001 a Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; CHOL, cholesterol; FBS, fasting blood sugar; HOMA-IR, homeostasis model assessment index for insulin resistance; TG, triglyceride Hepat Mon. 2012;12(8):e6099