Effects of a polypill on circulating levels of resistin and visfatin in men with non-alcoholic fatty liver disease: A five-year clinical trial

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease globally, characterized by insulin resistance, hypertension, and obesity. Adipokines such as resistin and visfatin play significant roles in glucose homeostasis and lipid metabolism. Polypills are utilized to improve cardiovascular disease (CVD) risk factors. The present observational study was nested within the PolyIran-Liver randomized controlled trial, which primarily assessed clinical outcomes in NAFLD patients. This study aimed to evaluate the effects of prolonged polypill consumption (five years) on circulating levels of resistin and visfatin as secondary outcomes in men with NAFLD. Participants from the PolyIran-Liver trial were included, comprising 41 patients in the control group and 40 patients in the polypill group, all of whom were men. The polypill regimen included aspirin, hydrochlorothiazide, atorvastatin, and valsartan. Treatment with the polypill resulted in a significant reduction in visfatin levels (2.27 ± 0.83 ng/ml vs. 2.10 ± 0.71 ng/ml, AdjP = 0.041), but no significant changes in resistin levels were observed within the polypill group (19.54 ± 4.11 ng/ml vs. 19.11 ± 3.08 ng/ml, AdjP = 0.396). The reduction in visfatin levels from baseline was significantly associated with changes in resistin levels and fasting blood glucose (FBG) (P < 0.05). Additionally, polypill intervention improved alanine aminotransferase (ALT) levels, lipid profiles, and systolic blood pressure in patients with NAFLD (P < 0.05). Our findings suggest that daily intake of the polypill can lead to significant reductions in visfatin levels and improvements in metabolic parameters in men with NAFLD. Further studies are needed to evaluate the long-term implications of polypill consumption in managing NAFLD through targeting adipokines.