{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:48:55Z","timestamp":1787240935167,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003035","name":"Aase og Ejnar Danielsens Fond","doi-asserted-by":"publisher","award":["10\u2010002192"],"award-info":[{"award-number":["10\u2010002192"]}],"id":[{"id":"10.13039\/501100003035","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Portal hypertension is the main determinant of clinical decompensation in patients with liver cirrhosis. In preclinical data metformin lowers portal pressure, but there are no clinical data for this beneficial effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate the acute effects of metformin on hepatic venous pressure gradient (HVPG) and liver perfusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a randomised, double\u2010blinded study design, we investigated 32 patients with cirrhosis before and 90\u00a0minutes after ingestion of 1000\u2010mg metformin (n\u00a0=\u00a016) or placebo (n\u00a0=\u00a016). Liver vein catherisation was performed to evaluate HVPG and indocyanine green (ICG) infusion for investigation of hepatic blood flow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean relative change in HVPG was \u221216% (95% CI: \u221228% to \u22124%) in the metformin group compared with 4% (95% CI: \u22126% to 14%) in the placebo group (time\u00a0\u00d7\u00a0group interaction,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.008). In patients with baseline HVPG \u226512\u00a0mm Hg clinically significant improvements in HVPG (HVPG &lt;12\u00a0mm Hg or a &gt;20% reduction in HVPG) were observed in 46% (6\/13) of metformin\u2010treated and in 8% (1\/13) of placebo\u2010treated patients (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.07). There were no changes or differences in systemic blood pressure, heart rate, hepatic plasma and blood flow, hepatic ICG clearance, hepatic O\n                      <jats:sub>2<\/jats:sub>\n                      uptake or inflammation markers between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A single oral metformin dose acutely reduces HVPG in patients with portal hypertension without affecting systemic or liver hemodynamics or inflammatory biomarkers. This offers a promising perspective of a safe and inexpensive treatment option that should be investigated in larger\u2010scale clinical studies with long\u2010term outcomes in patients with cirrhosis and portal hypertension.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.16460","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T07:20:51Z","timestamp":1624519251000},"page":"320-328","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Randomised clinical study: acute effects of metformin versus placebo on portal pressure in patients with cirrhosis and portal hypertension"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9938-2181","authenticated-orcid":false,"given":"Nikolaj","family":"Rittig","sequence":"first","affiliation":[{"name":"Steno Diabetes Center Aarhus Aarhus University Hospital Aarhus Denmark"},{"name":"Department and 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