Novel glucose-lowering drugs for non-alcoholic fatty liver disease

• 作者: Ming-Ming Zhao Ran Li Wen-Jia Yang Xiao-Ling Cai Yu-Feng Li Zuo-Di Fu
• 来源期刊: 世界糖尿病杂志:英文版(电子版)
• 学科: 医学
• 关键词: Non-alcoholic fatty liver disease Glucose-lowering drug META-ANALYSIS Dipeptidyl peptidase-4 inhibitor Sodium-glucose cotransporter 2 inhibitor Glucagon-like peptide-1 receptor agonist
• 年，卷（期）: 2021,（1）
• 页码范围: 84-97
• 页数: 14页
• 分类号: R57

摘要

BACKGROUND The efficacy of novel glucose-lowering drugs in treating non-alcoholic fatty liver disease(NAFLD)is unknown.AIM To evaluate the efficacy of glucose-lowering drugs dipeptidyl peptidase-4(DPP-4)inhibitors,glucagon-like peptide-1 receptor agonists(GLP-1 RAs),and sodiumglucose cotransporter 2(SGLT2)inhibitors in treating NAFLD and to perform a comparison between these treatments.METHODS Electronic databases were systematically searched.The inclusion criteria were:Randomized controlled trials comparing DPP-4 inhibitors,GLP-1 RAs,or SGLT2 inhibitors against placebo or other active glucose-lowering drugs in NAFLD patients,with outcomes of changes in liver enzyme[alanine aminotransferase(ALT)and/or aspartate aminotransferase(AST)]from baseline.RESULTS Nineteen studies were finally included in this meta-analysis.Compared with placebo or other active glucose-lowering drug treatment,treatment with DPP-4 inhibitors,GLP-1 RAs,and SGLT2 inhibitors all led to a significant decrease in ALT change and AST change from baseline.The difference between the DPP-4 inhibitor and SGLT2 inhibitor groups in ALT change was significant in favor of DPP-4 inhibitor treatment(P<0.05).The trends of reduction in magnetic resonance imaging proton density fat fraction and visceral fat area changes were also observed in all the novel glucose-lowering agent treatment groups.CONCLUSION Treatment with DPP-4 inhibitors,GLP-1 RAs,and SGLT2 inhibitors resulted in improvements in serum ALT and AST levels and body fat composition,indicating a beneficial effect in improving liver injury and reducing liver fat in NAFLD patients.