Effect of Telmisartan or Losartan for Treatment of Nonalcoholic Fatty Liver Disease: Fatty Liver Protection Trial by Telmisartan or Losartan Study (FANTASY)

• Main Authors: Takumi Hirata, Kengo Tomita, Toshihide Kawai, Hirokazu Yokoyama, Akira Shimada, Masahiro Kikuchi, Hiroshi Hirose, Hirotoshi Ebinuma, Junichiro Irie, Keisuke Ojiro, Yoichi Oikawa, Hidetsugu Saito, Hiroshi Itoh, Toshifumi Hibi
• Format: Article
• Language: English
• Published: Hindawi Limited 2013-01-01
• Series: International Journal of Endocrinology
• Online Access: http://dx.doi.org/10.1155/2013/587140

Aim. This study compared the effects of telmisartan and losartan on nonalcoholic fatty liver disease (NAFLD) and biochemical markers of insulin resistance in hypertensive NAFLD patients with type 2 diabetes mellitus. Methods. This was a randomized, open-label, parallel-group comparison of therapy with telmisartan or losartan. Nineteen hypertensive NAFLD patients with type 2 diabetes were randomly assigned to receive telmisartan at a dose of 20 mg once a day (n=12) or losartan at a dose of 50 mg once a day (n=7) for 12 months. Body fat area as determined by CT scanning and hepatic fat content based on the liver-to-spleen (L/S) ratio, as well as several parameters of glycemic and lipid metabolism, were compared before and after 12 months. Results. The telmisartan group showed a significant decline in serum free fatty acid (FFA) level (from 0.87±0.26 to 0.59±0.22 mEq/L (mean ± SD), P=0.005) and a significant increase in L/S ratio (P=0.049) evaluated by CT scan, while these parameters were not changed in the losartan group. Conclusion. Although there was no significant difference in improvement in liver enzymes with telmisartan and losartan treatment in hypertensive NAFLD patients with type 2 diabetes after 12 months, it is suggested that telmisartan may exert beneficial effects by improving fatty liver.