Research Article
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Year 2020, Volume: 42 Issue: 4, 491 - 499, 31.12.2020
https://doi.org/10.7197/cmj.835387

Abstract

References

  • 1. Williams, C.D., et al., Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology, 2011. 140(1): p. 124-31.
  • 2. Ceriello, A., et al., DPP-4 inhibitors: pharmacological differences and their clinical implications. Expert Opin Drug Saf, 2014. 13 Suppl 1: p. S57-68.
  • 3. Drucker, D.J. and M.A. Nauck, The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. Lancet, 2006. 368(9548): p. 1696-705.
  • 4. Matikainen, N., et al., Vildagliptin therapy reduces postprandial intestinal triglyceride-rich lipoprotein particles in patients with type 2 diabetes. Diabetologia, 2006. 49(9): p. 2049-57.
  • 5. Derosa, G., et al., Vildagliptin compared to glimepiride on post-prandial lipemia and on insulin resistance in type 2 diabetic patients. Metabolism, 2014. 63(7): p. 957-67.
  • 6. Ahren, B., et al., Improved meal-related beta-cell function and insulin sensitivity by the dipeptidyl peptidase-IV inhibitor vildagliptin in metformin-treated patients with type 2 diabetes over 1 year. Diabetes Care, 2005. 28(8): p. 1936-40.
  • 7. Mari, A., et al., Vildagliptin, a dipeptidyl peptidase-IV inhibitor, improves model-assessed beta-cell function in patients with type 2 diabetes. J Clin Endocrinol Metab, 2005. 90(8): p. 4888-94.
  • 8. Association, A.D., 2. Classification and diagnosis of diabetes. Diabetes care, 2015. 38(Supplement 1): p. S8-S16.
  • 9. Fracanzani, A.L., et al., Carotid artery intima-media thickness in nonalcoholic fatty liver disease. Am J Med, 2008. 121(1): p. 72-8.
  • 10. Subasi, C.F., U.E. Aykut, and Y. Yilmaz, Comparison of noninvasive scores for the detection of advanced fibrosis in patients with nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol, 2015. 27(2): p. 137-41.
  • 11. Bedogni, G., et al., The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol, 2006. 6: p. 33.
  • 12. Martinez, S.M., et al., Noninvasive assessment of liver fibrosis. Hepatology, 2011. 53(1): p. 325-35.
  • 13. Ali, R. and K. Cusi, New diagnostic and treatment approaches in non-alcoholic fatty liver disease (NAFLD). Ann Med, 2009. 41(4): p. 265-78.
  • 14. Marra, F., et al., Molecular basis and mechanisms of progression of non-alcoholic steatohepatitis. Trends Mol Med, 2008. 14(2): p. 72-81.
  • 15. Liu, Y., et al., [Therapeutic effect of saxagliptin in rat models of nonalcoholic fatty liver and type 2 diabetes]. Nan Fang Yi Ke Da Xue Xue Bao, 2014. 34(6): p. 862-8.
  • 16. Mashitani, T., et al., Efficacy of alogliptin in preventing non-alcoholic fatty liver disease progression in patients with type 2 diabetes. Biomed Rep, 2016. 4(2): p. 183-187.
  • 17. Balaban, Y.H., et al., Dipeptidyl peptidase IV (DDP IV) in NASH patients. Ann Hepatol, 2007. 6(4): p. 242-50.
  • 18. Yilmaz, Y., et al., Dipeptidyl peptidase IV inhibitors: therapeutic potential in nonalcoholic fatty liver disease. Med Sci Monit, 2009. 15(4): p. HY1-5.
  • 19. Macauley, M., et al., Effect of vildagliptin on hepatic steatosis. J Clin Endocrinol Metab, 2015. 100(4): p. 1578-85.
  • 20. Shirakawa, J., et al., Diet-induced adipose tissue inflammation and liver steatosis are prevented by DPP-4 inhibition in diabetic mice. Diabetes, 2011. 60(4): p. 1246-57.
  • 21. Kaji, K., et al., Dipeptidyl peptidase-4 inhibitor attenuates hepatic fibrosis via suppression of activated hepatic stellate cell in rats. J Gastroenterol, 2014. 49(3): p. 481-91.
  • 22. Kaji, K., et al., Impact of insulin resistance on the progression of chronic liver diseases. Int J Mol Med, 2008. 22(6): p. 801-8.
  • 23. Ben-Shlomo, S., et al., Glucagon-like peptide-1 reduces hepatic lipogenesis via activation of AMP-activated protein kinase. J Hepatol, 2011. 54(6): p. 1214-23.
  • 24. Svegliati-Baroni, G., et al., Glucagon-like peptide-1 receptor activation stimulates hepatic lipid oxidation and restores hepatic signalling alteration induced by a high-fat diet in nonalcoholic steatohepatitis. Liver Int, 2011. 31(9): p. 1285-97.
  • 25. Machado, M.V. and H. Cortez-Pinto, Non-invasive diagnosis of non-alcoholic fatty liver disease. A critical appraisal. J Hepatol, 2013. 58(5): p. 1007-19.

The efficacy and safety of vildagliptin treatment for nonalcoholic fatty liver disease in type 2 diabetes mellitus

Year 2020, Volume: 42 Issue: 4, 491 - 499, 31.12.2020
https://doi.org/10.7197/cmj.835387

Abstract

Objective: Effects of dipeptidyl peptidase-4 inhibitors on liver function and glucose metabolism in nonalcoholic fatty liver disease (NAFLD) have not been well determined. The aim of this study was to evaluate the effect of vildagliptin on liver functions and hepatic steatosis and also to evaluate efficacy and safety of vildagliptin in NAFLD patients with type 2 diabetes mellitus (DM).
Method: Fifty-four patients with type 2 DM, complicated with ultrasonography (USG) diagnosed NAFLD were prospectively enrolled in the study from June 2014 to June 2015 in Bozok University Hospital. All patients were subjected to lifestyle intervention of diet and physical exercise after the diagnosis of type 2 DM. Vildaliptin treatment was given 100mg per day. Liver non-invasive assessment tools such as, Fatty Liver Index (FLI), FIB-4 index, APRI Score, and other laboratory parameters were also evaluated before, 3 and 6 months after the initiation of treatment. 
Results: HbA1c was reduced from 9.22% (8.07-10.35) to 7.26% (6.27-8.10) (P < 0.001). During vildagliptin treatment, ALT levels improved from 30.91 ± 26.48 to 25.94 ± 14.8 IU/L (P < 0.05). The serum levels of TG and LDL decreased with statistical significance (P < 0.05). WC and BMI were also decreased (P < 0.001). FLI and APRI scores improved at 6 months after the initiation of vildagliptin (P < 0.05). Patients showed improvement for fatty liver severity by USG after vildagliptin treatment (P < 0.001). All the patients took vildagliptin of 100mg/day without reduction necessitated by related side-effects.
Conclusions: Our preliminary study results showed that vildagliptin treatment have positive effect on blood sugar regulation, body composition, ALT, liver fibrosis and steatosis indexes in type 2 DM complicated with NAFLD. Vildagliptin seems to be effective and safe in NAFLD patients with type 2 DM.

References

  • 1. Williams, C.D., et al., Prevalence of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis among a largely middle-aged population utilizing ultrasound and liver biopsy: a prospective study. Gastroenterology, 2011. 140(1): p. 124-31.
  • 2. Ceriello, A., et al., DPP-4 inhibitors: pharmacological differences and their clinical implications. Expert Opin Drug Saf, 2014. 13 Suppl 1: p. S57-68.
  • 3. Drucker, D.J. and M.A. Nauck, The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. Lancet, 2006. 368(9548): p. 1696-705.
  • 4. Matikainen, N., et al., Vildagliptin therapy reduces postprandial intestinal triglyceride-rich lipoprotein particles in patients with type 2 diabetes. Diabetologia, 2006. 49(9): p. 2049-57.
  • 5. Derosa, G., et al., Vildagliptin compared to glimepiride on post-prandial lipemia and on insulin resistance in type 2 diabetic patients. Metabolism, 2014. 63(7): p. 957-67.
  • 6. Ahren, B., et al., Improved meal-related beta-cell function and insulin sensitivity by the dipeptidyl peptidase-IV inhibitor vildagliptin in metformin-treated patients with type 2 diabetes over 1 year. Diabetes Care, 2005. 28(8): p. 1936-40.
  • 7. Mari, A., et al., Vildagliptin, a dipeptidyl peptidase-IV inhibitor, improves model-assessed beta-cell function in patients with type 2 diabetes. J Clin Endocrinol Metab, 2005. 90(8): p. 4888-94.
  • 8. Association, A.D., 2. Classification and diagnosis of diabetes. Diabetes care, 2015. 38(Supplement 1): p. S8-S16.
  • 9. Fracanzani, A.L., et al., Carotid artery intima-media thickness in nonalcoholic fatty liver disease. Am J Med, 2008. 121(1): p. 72-8.
  • 10. Subasi, C.F., U.E. Aykut, and Y. Yilmaz, Comparison of noninvasive scores for the detection of advanced fibrosis in patients with nonalcoholic fatty liver disease. Eur J Gastroenterol Hepatol, 2015. 27(2): p. 137-41.
  • 11. Bedogni, G., et al., The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. BMC Gastroenterol, 2006. 6: p. 33.
  • 12. Martinez, S.M., et al., Noninvasive assessment of liver fibrosis. Hepatology, 2011. 53(1): p. 325-35.
  • 13. Ali, R. and K. Cusi, New diagnostic and treatment approaches in non-alcoholic fatty liver disease (NAFLD). Ann Med, 2009. 41(4): p. 265-78.
  • 14. Marra, F., et al., Molecular basis and mechanisms of progression of non-alcoholic steatohepatitis. Trends Mol Med, 2008. 14(2): p. 72-81.
  • 15. Liu, Y., et al., [Therapeutic effect of saxagliptin in rat models of nonalcoholic fatty liver and type 2 diabetes]. Nan Fang Yi Ke Da Xue Xue Bao, 2014. 34(6): p. 862-8.
  • 16. Mashitani, T., et al., Efficacy of alogliptin in preventing non-alcoholic fatty liver disease progression in patients with type 2 diabetes. Biomed Rep, 2016. 4(2): p. 183-187.
  • 17. Balaban, Y.H., et al., Dipeptidyl peptidase IV (DDP IV) in NASH patients. Ann Hepatol, 2007. 6(4): p. 242-50.
  • 18. Yilmaz, Y., et al., Dipeptidyl peptidase IV inhibitors: therapeutic potential in nonalcoholic fatty liver disease. Med Sci Monit, 2009. 15(4): p. HY1-5.
  • 19. Macauley, M., et al., Effect of vildagliptin on hepatic steatosis. J Clin Endocrinol Metab, 2015. 100(4): p. 1578-85.
  • 20. Shirakawa, J., et al., Diet-induced adipose tissue inflammation and liver steatosis are prevented by DPP-4 inhibition in diabetic mice. Diabetes, 2011. 60(4): p. 1246-57.
  • 21. Kaji, K., et al., Dipeptidyl peptidase-4 inhibitor attenuates hepatic fibrosis via suppression of activated hepatic stellate cell in rats. J Gastroenterol, 2014. 49(3): p. 481-91.
  • 22. Kaji, K., et al., Impact of insulin resistance on the progression of chronic liver diseases. Int J Mol Med, 2008. 22(6): p. 801-8.
  • 23. Ben-Shlomo, S., et al., Glucagon-like peptide-1 reduces hepatic lipogenesis via activation of AMP-activated protein kinase. J Hepatol, 2011. 54(6): p. 1214-23.
  • 24. Svegliati-Baroni, G., et al., Glucagon-like peptide-1 receptor activation stimulates hepatic lipid oxidation and restores hepatic signalling alteration induced by a high-fat diet in nonalcoholic steatohepatitis. Liver Int, 2011. 31(9): p. 1285-97.
  • 25. Machado, M.V. and H. Cortez-Pinto, Non-invasive diagnosis of non-alcoholic fatty liver disease. A critical appraisal. J Hepatol, 2013. 58(5): p. 1007-19.
There are 25 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Medical Science Research Articles
Authors

Ahmet Aktaş 0000-0001-9464-0700

Zeynep Ozan 0000-0002-4654-8982

Publication Date December 31, 2020
Acceptance Date December 17, 2020
Published in Issue Year 2020Volume: 42 Issue: 4

Cite

AMA Aktaş A, Ozan Z. The efficacy and safety of vildagliptin treatment for nonalcoholic fatty liver disease in type 2 diabetes mellitus. CMJ. December 2020;42(4):491-499. doi:10.7197/cmj.835387