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.