Efficacy of metformin versus <scp>l</scp>‐carnitine in vitamin E‐treated patients with nonalcoholic fatty liver disease: A randomized controlled clinical trial

Abstract The present research evaluated the impact of concurrent administration of metformin and l ‐carnitine with vitamin E on sonography grade as well as on the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in patients diagnosed with nonalcoholic fatty liver disease (NAFLD). This randomized controlled clinical trial was conducted on 68 non‐metabolic patients diagnosed with NAFLD, confirmed by sonography and clinical examinations. Patients were randomly allocated to two groups: 34 individuals received 1 g of l ‐carnitine per day, the other 34 individuals received 1000 mg of metformin per day, both for a period of 6 months. All the studied patients received 800 IU of vitamin E daily for 6 months. The sonography grade of the fatty liver and the levels of ALT and AST in patients were evaluated at three time points: at the beginning of the trial and at 3 and 6 months after the study initiation. After 6 months of treatment, the administration of metformin and vitamin E resulted in a reduction in the sonography grade of patients diagnosed with NAFLD ( p &lt; .05). In contrast, there was no improvement in the sonography grade of patients who received l ‐carnitine and vitamin E. There were no notable alterations in the levels of liver enzymes (both ALT and AST) in either group ( p &gt; .05). The simultaneous use of metformin and vitamin E significantly improves the sonography grade of fatty liver, but not the level of liver enzymes in individuals with NAFLD.