Efficacy of liraglutide in treating type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease

Abstract

Type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD) is difficult to treat. The present study explored the efficacy of (liraglutide) Lira in treating T2DM complicated with NAFLD. A total of 127 patients suffering from T2DM complicated with NAFLD were enrolled in the present study, and randomly assigned to a Lira group (liraglutide injection: 0.6–1.2 mg/day, 12 weeks, n=52) or a Metformin (Met) group (oral metformin: 1000–1500 mg/day, 12 weeks, n=75). During the treatment phase, the values for fasting plasma glucose (FPG), 2 h plasma glucose (2hPG), glycated hemoglobin (HbA1c), aspartate aminotransferase (AST)/alanine aminotransferase (ALT), and adiponectin (APN) decreased in both the Lira and Met groups, and the levels of Δ2hPG, ΔAST/ALT, and ΔAPN in the Lira group were significantly lower than those in the Met group. The values for total cholesterol (TC), triglycerides (TG), low-and high-density lipoproteins (LDL and HDL), ALT, AST, weight, body mass index (BMI), waist to hip ratio (WHR), and C-reactive protein were markedly increased in both groups, and levels of ΔAST, ΔALT, Δweight, ΔBMI, ΔWHR, and ΔCRP (C-reactive protein) in the Lira group were significantly higher than those in the Met group. An analysis of treatment efficacy showed that liraglutide was better than metformin in its ability to significantly decrease the ALT levels in patients with combined T2DM and NAFLD. Furthermore, liraglutide was more effective than metformin at ameliorating the severity of T2DM complicated with NAFLD, and produced its effects by alleviating liver inflammation and improving liver function.

Determining whether the effect of liraglutide on non‐alcoholic fatty liver disease depends on reductions in the body mass index

“…8 Liraglutide ameliorates liver enzymes, histological features, and liver fat content. [9][10][11] These effects may be due to improvements in weight loss, which is a consistent finding in GLP-1 RA treatment. 2 However, few studies have investigated whether the effect of GLP-1 RAs depends on changes in a patient's body mass index (BMI).…”

“…These findings complement those of previous studies, which showed that liraglutide improved the ALT, AST, APRI, and histological features of patients with type 2 diabetes and NAFLD. [8][9][10][11] Although liver biopsy is the gold standard for diagnosing NAFLD/NASH, this procedure is difficult to perform in these patients due to its highly invasive nature; moreover, it increases the risk for sampling errors and postprocedure complications. 22 Ultrasonography is used more often for screening fat deposition because it is relatively inexpensive and safe.…”

Beneficial effect of anti-diabetic drugs for nonalcoholic fatty liver disease

“…Many studies showed that liraglutide reduced liver enzymes. 49,50 In a meta-analysis of six RCTs conducted by the "Liraglutide Effect and Action in Diabetes (LEAD)" program, 26 weeks of liraglutide treatment (1.8 mg/day) improved ALT and hepatic steatosis in 4,442 patients with T2DM. 49 However, these effects were likely mediated by weight loss and glycemic control, since they were lost after adjustment for weight reduction and HbA1c.…”

Network Pharmacology Reveals the Multiple Mechanisms of Xiaochaihu Decoction in the Treatment of Non-alcoholic Fatty Liver Disease

“…The pathways related to metabolism included AGE-RAGE signaling pathway in diabetic complications, Fluid shear stress and atherosclerosis and Insulin resistance. According to previous statistics, NAFLD is a common complication of diabetes [34]. The accumulation of fat caused by NAFLD will increase insulin resistance, which will affect the liver's export of hepatic glycogen.…”