Comparative effectiveness of glucagon-like peptide-1 receptor agonists versus dipeptidyl peptidase-4 inhibitors on noninvasive indices of hepatic steatosis and fibrosis in patients with type 2 diabetes mellitus期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

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Comparative effectiveness of glucagon-like peptide-1 receptor agonists versus dipeptidyl peptidase-4 inhibitors on noninvasive indices of hepatic steatosis and fibrosis in patients with type 2 diabetes mellitus

Institution:	1. First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece;2. Department of Endocrinology, Ippokration General Hospital, Thessaloniki, Greece

Abstract:	Background and aimsNonalcoholic fatty liver disease (NAFLD) is highly prevalent in patients with type 2 diabetes mellitus (T2DM). There is currently no approved treatment for NAFLD. The main aim was the evaluation of the effect of glucagon-like peptide-1 receptor agonists (GLP-1 RA) vs. dipeptidyl peptidase-4 inhibitor (DPP-4i) treatment on noninvasive indices of hepatic steatosis and fibrosis in patients with T2DM.MethodsIn this retrospective study, three noninvasive indices of hepatic steatosis HSI, NAFLD ridge score, and triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio] and five of fibrosis (APRI, FIB-4, NAFLD fibrosis score, BAAT and BARD) were calculated before and after (6–18 months) the addition of a DPP-4i (n = 152) or a GLP-1 RA (n = 37) in patients with T2DM.ResultsRegarding steatosis indices, NAFLD ridge score was significantly decreased in the GLP-1 RA group (baseline: 0.90 ± 0.34, follow-up: 0.67 ± 0.24; p = 0.001), but not in the DPP-4i group (p = 0.25); the difference for group1time interaction was significant (p = 0.02). HSI showed a trend between groups, being significantly different at baseline and follow-up (p < 0.001) with no significant difference in group1time interaction. Indices of fibrosis were not essentially changed within or between groups.ConclusionsNAFLD ridge score was significantly decreased after the addition of GLP-1 RA in patients with T2DM. This study warrants further prospective clinical trials.

Keywords:	Dipeptidyl peptidase-4 inhibitor Fibrosis Glucagon-like peptide-1 receptor agonist Nonalcoholic fatty liver disease Type 2 diabetes mellitus proton magnetic resonance spectroscopy ALT"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"alanine aminotransferase ANCOVA"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"analysis of covariance ANOVA"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"analysis of variance APRI"} {"#name":"keyword" "$":{"id":"kwrd0080"} "$$":[{"#name":"text" "_":"AST to platelet ratio index AST"} {"#name":"keyword" "$":{"id":"kwrd0090"} "$$":[{"#name":"text" "_":"aspartate aminotransferase BAAT"} {"#name":"keyword" "$":{"id":"kwrd0100"} "$$":[{"#name":"text" "_":"BMI-Age-ALT-Triglycerides score BARD"} {"#name":"keyword" "$":{"id":"kwrd0110"} "$$":[{"#name":"text" "_":"BMI-AST/ALT ratio-Diabetes score BMI"} {"#name":"keyword" "$":{"id":"kwrd0120"} "$$":[{"#name":"text" "_":"body mass index DPP-4i"} {"#name":"keyword" "$":{"id":"kwrd0130"} "$$":[{"#name":"text" "_":"dipeptidyl peptidase-4 inhibitor FIB-4"} {"#name":"keyword" "$":{"id":"kwrd0140"} "$$":[{"#name":"text" "_":"fibrosis-4 index GGT"} {"#name":"keyword" "$":{"id":"kwrd0150"} "$$":[{"#name":"text" "_":"gamma-glutamyl transferase GLP-1 RA"} {"#name":"keyword" "$":{"id":"kwrd0160"} "$$":[{"#name":"text" "_":"glucagon-like peptide-1 receptor agonist HbA1c"} {"#name":"keyword" "$":{"id":"kwrd0170"} "$$":[{"#name":"text" "_":"glycated hemoglobin HCC"} {"#name":"keyword" "$":{"id":"kwrd0180"} "$$":[{"#name":"text" "_":"hepatocellular carcinoma HDL-C"} {"#name":"keyword" "$":{"id":"kwrd0190"} "$$":[{"#name":"text" "_":"high-density lipoprotein cholesterol HSI"} {"#name":"keyword" "$":{"id":"kwrd0200"} "$$":[{"#name":"text" "_":"hepatic steatosis index LDL-C"} {"#name":"keyword" "$":{"id":"kwrd0210"} "$$":[{"#name":"text" "_":"low-density lipoprotein cholesterol LFTs"} {"#name":"keyword" "$":{"id":"kwrd0220"} "$$":[{"#name":"text" "_":"liver function tests MRI"} {"#name":"keyword" "$":{"id":"kwrd0230"} "$$":[{"#name":"text" "_":"magnetic resonance imaging MRI-PDFF"} {"#name":"keyword" "$":{"id":"kwrd0240"} "$$":[{"#name":"text" "_":"magnetic resonance imaging–estimated proton density fat fraction NAFL"} {"#name":"keyword" "$":{"id":"kwrd0250"} "$$":[{"#name":"text" "_":"nonalcoholic fatty liver NAFLD"} {"#name":"keyword" "$":{"id":"kwrd0260"} "$$":[{"#name":"text" "_":"nonalcoholic fatty liver disease NASH"} {"#name":"keyword" "$":{"id":"kwrd0270"} "$$":[{"#name":"text" "_":"nonalcoholic steatohepatitis NFS"} {"#name":"keyword" "$":{"id":"kwrd0280"} "$$":[{"#name":"text" "_":"NAFLD fibrosis score PLT"} {"#name":"keyword" "$":{"id":"kwrd0290"} "$$":[{"#name":"text" "_":"platelet T2DM"} {"#name":"keyword" "$":{"id":"kwrd0300"} "$$":[{"#name":"text" "_":"type 2 diabetes mellitus TG"} {"#name":"keyword" "$":{"id":"kwrd0310"} "$$":[{"#name":"text" "_":"triglycerides US"} {"#name":"keyword" "$":{"id":"kwrd0320"} "$$":[{"#name":"text" "_":"ultrasound WBC"} {"#name":"keyword" "$":{"id":"kwrd0330"} "$$":[{"#name":"text" "_":"white blood cells
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