Metformin and atorvastatin combination further protect the liver in type 2 diabetes with hyperlipidaemia

Background Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes are associated with dyslipidaemia, inflammation and oxidative stress. However, the pathophysiology of NAFLD in type 2 diabetes with hyperlipidaemia is not fully known, as well as the utility of the commonly prescribed anti-diabetic and lipid-lowering drugs in ameliorating liver injury markers. Methods Hepatic complications of type 2 diabetes with hyperlipidaemia and the effects of atorvastatin and metformin, isolated and in association, in systemic and hepatic inflammatory and oxidative stress markers were tested using genetic type 2 diabetic Goto-Kakizaki rats fed with a high-fat diet. Results The high-fat diet aggravated the overall metabolic state and the hepatic markers of injury. All treatments decreased fasting glycaemia, insulin resistance and free fatty acid levels. Combined treatment further decreased C-reactive protein (CRP), adiponectin, liver tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6), systemic and hepatic oxidative stress and portal inflammation. Conclusions Our data provides evidence of a greater benefit with a combination of atorvastatin and metformin in improving liver injury in type 2 diabetes with hyperlipidaemia. Copyright (C) 2010 John Wiley & Sons, Ltd.