Antiapoptotic effect of melatonin in nonalcoholic steatohepatitis developing in patients with type 2 diabetes mellitus

Objective — to investigate the antiapoptotic effect of melaxen in nonalcoholic steatohepatitis associated with type 2 diabetes mellitus, as well as its effect on markers of cytolysis syndrome, parameters of lipid and carbohydrate metabolism. Material and methods . Fifty-nine patients with nonalcoholic steatohepatitis associated with type 2 diabetes mellitus were included in the clinical study. Among them, 33 people were receiving background therapy; 26 patients received melaxen in addition to the background therapy. Biochemical values (aminotransferases, the lipid and carbohydrate profile) were measured using the conventional methods. Activities of caspase-1 and -3 in blood serum were determined spectrophotometrically. DNA fragmentation from white blood cells was detected by agarose gel electrophoresis followed by staining with ethidium bromide. Results . It was shown that in this pathology, apoptotic processes are activated in addition to development of the cytolysis syndrome and disturbances of lipid and carbohydrate metabolism as evidenced by the increased caspase-1 and -3 activities. DNA fragmentation also took place. Activities of caspase-1 and 3 increased 1.7-fold (p<0.05) and 1.8-fold (p<0.05) compared with the normal values. The characteristic apoptotic «ladder» was also detected in the electrophoregram of DNA isolated from blood lymphocytes in patients with nonalcoholic steatohepatitis associated with type 2 diabetes mellitus. The combination therapy with melaxen changed the investigated parameters towards the normal values more significantly compared to the background treatment. Conclusions . Hence, melatonin possesses antiapoptotic activity and can have a positive impact on treatment efficiency.