Effect of incretin therapies compared to pioglitazone and gliclazide in non-alcoholic fatty liver disease in diabetic patients not controlled on metformin alone: An observational, pilot study

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• 作者：Eduardo Garcí ; a Dí ; az^a ; ^{eduardogd@terra.com" class="auth_mail" title="E-mail the corresponding author} ; Danila Guagnozzi^b ; ^&loz ; ; Veró ; nica Gutié ; rrez^c ; Carmen Mendoza^c ; Cristina Maza^c ; Yulene Larrañ ; aga^c ; Dolores Perdomo^c ; Teresa Godoy^c ; Ghalli Taleb^c
• 关键词：Non-alcoholic fatty liver disease ; GLP-1 ; Thiazolidinediones
• 刊名：Endocrinología y Nutrición (English Edition)
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：63
• 期：5
• 页码：194-201
• 全文大小：663 K

文摘

To compare the effect of different hypoglycemic drugs on laboratory and ultrasonographic markers of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes not controlled on metformin alone.

Methods

Prospective study of diabetic patients treated with metformin in combination with gliclazide, pioglitazone, sitagliptin, exenatide, or liraglutide. NAFLD was assessed by abdominal ultrasound and NAFLD fibrosis score was calculated at baseline and 6 months.

Results

Fifty-eight patients completed 6 months of follow-up: 15 received gliclazide, 13 pioglitazone, 15 sitagliptin, 7 exenatide, and 8 liraglutide. NAFLD affected 57.8% of patients at baseline, and its ultrasonographic course varied depending on changes in weight (P = .009) and waist circumference (P = .012). The proportions of patients who experienced ultrasonographic improvement in the different treatment groups were: 33.3% with gliclazide, 37.5% with pioglitazone, 45.5% with sitagliptin, 80% with exenatide, and 33% with liraglutide (P = .28).

Conclusions

Qualitative ultrasonographic NAFLD improvement in diabetic patients treated with metformin in combination with other hypoglycemic drugs is associated to change over time in weight and waist circumference. Long-term clinical trials are needed to assess whether incretin therapies result in better liver outcomes than other hypoglycemic therapies.