In addition , there was a low level of evidence that hypercaloric fructose and glucose diets have similar effects on liver fat and liver enzymes in healthy adults .
There was insufficient evidence to draw a conclusion for effects of HFCS or sucrose on NAFLD .
Conclusions : On the basis of indirect comparisons across study findings , the apparent association between indexes of liver health ( ie , liver fat , hepatic de novo lipogenesis , alanine aminotransferase , AST , and γ-glutamyl transpeptase ) and fructose or sucrose intake appear to be confounded by excessive energy intake .
Overall , the available evidence is not sufficiently robust to draw conclusions regarding effects of fructose , HFCS , or sucrose consumption on NAFLD
Background : Concerns have been raised about the concurrent temporal trend between simple sugar intakes , especially of fructose or high-fructose corn syrup ( HFCS ) , and rates of nonalcoholic fatty liver disease ( NAFLD ) in the United States .
Objective : We examined the effect of different amounts and forms of dietary fructose on the incidence or prevalence of NAFLD and indexes of liver health in humans .
A Randomized Controlled Trial of Metformin versus Vitamin E or Prescriptive Diet in Nonalcoholic Fatty Liver Disease
OBJECTIVES : Metformin proved useful in the treatment of nonalcoholic fatty liver disease ( NAFLD ) , but its superiority over nutritional treatment and antioxidants has never been demonstrated . We aim ed to compare the usefulness of metformin versus prescriptive diet or vitamin E. METHODS : In an open label , r and omized trial , nondiabetic NAFLD patients were given metformin ( 2 g/day ; n = 55 ) for 12 months . The control cases were given either vitamin E ( 800 IU/day ; n = 28 ) or were treated by a prescriptive , weight-reducing diet ( n = 27 ) . Outcome measures were liver enzymes , insulin resistance ( homeostasis model assessment ) , parameters of the metabolic syndrome , and histology . RESULTS : Aminotransferase levels improved in all groups , in association with weight loss . The effects in the metformin arm were larger ( p < 0.0001 ) , and alanine aminotransferase normalized in 56 % of cases ( odds ratio ( OR ) versus . controls , 3.11 ; 95 % confidence interval ( CI ) , 1.56–6.20 ; p = 0.0013 ) . In multivariate analysis , metformin treatment was associated with higher rates of aminotransferase normalization , after correction for age , gender , basal aminotransferases , and change in body mass index ( OR , 5.98 ; 95 % CI , 2.05–17.45 ) . Differences were maintained when the two control groups were separately analyzed . The distribution of positive criteria for the metabolic syndrome was reduced only in the metformin arm ( p = 0.001 , signed rank test ) . A control biopsy in 17  metformin-treated cases ( 14 nonresponders ) showed a significant decrease in liver fat ( p = 0.0004 ) , necroinflammation , and fibrosis ( p = 0.012 for both ) . No side effects were observed during metformin treatment . CONCLUSIONS : Metformin treatment is better than a prescriptive diet or vitamin E in the therapy of NAFLD patients receiving nutritional counseling . Limited histological data support an association between improved aminotransferases and biopsy findings , which require confirmation in a double-blind trial with appropriate statistical power based on liver histology
In addition , there was a low level of evidence that hypercaloric fructose and glucose diets have similar effects on liver fat and liver enzymes in healthy adults .
There was insufficient evidence to draw a conclusion for effects of HFCS or sucrose on NAFLD .
Conclusions : On the basis of indirect comparisons across study findings , the apparent association between indexes of liver health ( ie , liver fat , hepatic de novo lipogenesis , alanine aminotransferase , AST , and γ-glutamyl transpeptase ) and fructose or sucrose intake appear to be confounded by excessive energy intake .
Overall , the available evidence is not sufficiently robust to draw conclusions regarding effects of fructose , HFCS , or sucrose consumption on NAFLD
Background : Concerns have been raised about the concurrent temporal trend between simple sugar intakes , especially of fructose or high-fructose corn syrup ( HFCS ) , and rates of nonalcoholic fatty liver disease ( NAFLD ) in the United States .
Objective : We examined the effect of different amounts and forms of dietary fructose on the incidence or prevalence of NAFLD and indexes of liver health in humans .