Hypoglycemic agents for non-alcoholic fatty liver disease with type 2 diabetes mellitus

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Western countries, and strongly associated with type 2 diabetes mellitus (T2DM). Several studies have shown that hypoglycemic agents are effective for NAFLD combined with T2DM. However, there is still controversy over which hypoglycemic agent is the best for NAFLD combined with T2DM patients. Objective: To systematically evaluate the efficacy and safety of hypoglycemic agents in NAFLD combined with T2DM patients. Methods: A comprehensive electronic search will be conducted by searching Web of Science, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Clinical Trials and Chinese Biomedical Medicine. All randomized controlled trials of hypoglycemic agents interventions for NAFLD combined with T2DM will be identified. Two reviewers independently screened and evaluated each included study and extracted the outcome indexes. ADDIS 1.16.8 software will be used for the network meta-analysis and STATA 14 software will be used for drawing network evidence plots and funnel plots. Conclusion: This network meta-analysis will provide stronger evidence for the efficacy and safety of hypoglycemic agents in the treatment of NAFLD combined with T2DM, and provide a reference for clinical application. Protocol registration number: INPLASY202070016.

Assessment of Classification Models and Relevant Features on Nonalcoholic Steatohepatitis Using Random Forest

“…Obesity, metabolic syndrome, and insulin resistance play a role in both NAFLD and NASH because dysregulation of several adipokines induced by hyperinsulinemia may lead to local inflammatory processes and liver damage [ 57 , 58 , 59 ]. Another major clinical implication of our research is the identification of a therapeutic target: if insulin resistance is involved in the development of NASH, the use of hypoglycemic drugs can be useful for preventing NASH, as reported in a recent meta-analysis [ 60 ].…”

Comparison of efficacy of anti-diabetics on non-diabetic NAFLD: A network meta-analysis

“…The studies that met the inclusion criteria for this study involved 7 drugs of 5 categories, namely biguanides (metformin), DPP-4i (vildagliptin, sitagliptin), TZD class (rosiglitazone, pioglitazone), SGLT2i (empagliflozin), and GLP-1RA (liraglutide) drugs ( Ranjbar et al, 2019 ; Liu et al, 2020 ). As mentioned earlier, vildagliptin was the best AST-lowering drug and the second-ranked excellent ALT-lowering drug in our study.…”

“…and hypolipidemics ( Lazarus et al, 2020 ; Mantovani and Dalbeni, 2021 ; Rowe et al, 2022 ), etc. Anti-diabetic drugs have been increasingly tried as one of the commonly used pharmaceutical treatments besides the adjustment of diet and living habits for non-diabetic NAFLD patients in recent years, because it is widely accepted that insulin resistance may play an important role in the pathogenesis of NAFLD and there is a bidirectional interaction between NAFLD and type 2 diabetes NAFLD ( Mazza et al, 2012 ; Lonardo et al, 2019 ; Pennisi et al, 2019 ; Liu et al, 2020 ; Sumida et al, 2020 ). Clinically applied anti-diabetic drugs, other than insulin, can be divided into 7 categories, including: biguanides, sulfonylureas, thiazolidinediones (TZDs) [i.e.…”