Miglitol attenuates non‐alcoholic steatohepatitis in diabetic patients

Komatsu, Michiharu; Tanaka, Naoki; Fujimori, Naoyuki; Sakai, Kenji; Horiuchi, Akira; Sugiura, Ayumi; Yamazaki, Tomoo; Shibata, Soichiro; Joshita, Satoru; Umemura, Takeji; Matsumoto, Akihiro; Tanaka, Eiji

doi:10.1111/hepr.13223

Cited by 13 publications

(10 citation statements)

References 20 publications

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“…By favoring saccharolytic, instead of proteolytic, intestinal bacterial flora, acarbose treatment has also been shown to reduce serum ammonia level as well as to improve intellectual function in a randomized, placebo-controlled trial, crossover study[ 166 ], making it an effective regimen for the consolidated treatment of hyperglycemia and mild hepatic encephalopathy. In a small pilot study of diabetic patients with biopsy-confirmed NASH, miglitol was found to reduce aminotransferase levels, hepatic steatosis, and histological inflammation after 12 months of therapy[ 167 ]. Moreover, voglibose was found to be effective in minimizing pioglitazone-induced weight gain in the general diabetic population[ 168 ].…”

Section: Management Of Diabetes In Patients With Liver Diseasesmentioning

confidence: 99%

Clinical implications, diagnosis, and management of diabetes in patients with chronic liver diseases

Chung

Promrat

Wands

2020

WJH

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Diabetes mellitus (DM) negatively affects the development and progression of chronic liver diseases (CLD) of various etiologies. Concurrent DM and CLD are also associated with worse clinical outcomes with respect to mortality, the occurrence of hepatic decompensation, and the development of hepatocellular carcinoma (HCC). Unfortunately, early diagnosis and optimal treatment of DM can be challenging, due to the lack of established clinical guidelines as well as the medical complexity of this patient population. We conducted an exploratory review of relevant literature to provide an up-to-date review for internists and hepatologists caring for this patient population. We reviewed the epidemiological and pathophysiological associations between DM and CLD, the impact of insulin resistance on the progression and manifestations of CLD, the pathogenesis of hepatogenic diabetes, as well as the practical challenges in diagnosis and monitoring of DM in this patient population. We also reviewed the latest clinical evidence on various pharmacological antihyperglycemic therapies with an emphasis on liver disease-related clinical outcomes. Finally, we proposed an algorithm for managing DM in patients with CLD and discussed the clinical and research questions that remain to be addressed.

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Section: Management Of Diabetes In Patients With Liver Diseasesmentioning

confidence: 99%

Clinical implications, diagnosis, and management of diabetes in patients with chronic liver diseases

Chung

Promrat

Wands

2020

WJH

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“…The reasons for these factors may be due to the activity of multiple signaling pathways, but these mechanisms need to be further clarified. Currently, modern medical treatment of T2DM with NAFLD is mainly based on strict diet control and pharmacological treatment with metformin [ 9 ], thiazolidinediones [ 10 ], α-glucosidase inhibitor [ 11 ], and the glucagon-like receptor agonist GLP-1 RA [ 12 ]. However, there is no specific drug for this disease and the clinical efficacy needs to be further confirmed.…”

Section: Introductionmentioning

confidence: 99%

Tandem mass tag-based proteomics analysis of type 2 diabetes mellitus with non-alcoholic fatty liver disease in mice treated with acupuncture

Wang

et al. 2022

Bioscience Reports

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Objective: To explore the proteomics profiles of hepatocytes of mice treated with acupuncture for type 2 diabetes mellitus (T2DM) with non-alcoholic fatty liver disease (NAFLD). Methods: We used a Tandem mass tag (TMT)-based quantitative proteomics approach to identify proteins with potential molecular mechanisms associated with acupuncture interventions for T2DM with NAFLD. Results: Acupuncture effectively improved body weight, blood glucose, and insulin levels in T2DM with NAFLD mouse models and reversed steatosis within hepatocytes. Quantitative TMT- based proteomics analysis identified a total of 4710 quantifiable proteins and 1226 differentially expressed proteins (DEPs) in the model control group (MCG) compared to the normal control group (NCG). The Acupuncture Treatment Group (ATG) presented in 122 DEPs compared to the MCG group. We performed a bioinformatics analysis, which revealed that DEPs enriched in the KEGG pathway after acupuncture treatment were mainly involved in the PPAR signalling pathway, fatty acid biosynthesis, fatty acid metabolism, fatty acid elongation, fat digestion, and absorption. We used parallel reaction monitoring (PRM) technology to explore the association of aldehyde oxidase 1 (Aox1), acyl-coenzyme A thioesterase 2 (Acot2), perilipin-2 (Plin2), acetyl-CoA carboxylase 1 (Acc), NADP-dependent malic enzyme (Me1), fatty acid synthase (Fasn), ATP-citrate synthase (Acly), fatty acid binding protein (Fabp2) with lipid synthesis, fatty acid oxidation and hepatocyte steatosis. Conclusions: Our results show that acupuncture can regulate the protein expression of T2DM in the NAFLD mice model, and can effectively improve hepatocyte steatosis, and has potential benefits for the clinical treatment of this disease.

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“…99 Administration of miglitol (150 mg/day) for 12 months in 17 T2DM patients with histologically-confirmed NASH showed significantly decreased BMI and serum ALT. 100 Post-treatment liver biopsy of 11 patients revealed significant improvements in steatosis, lobular inflammation, portal inflammation scores, and NAFLD activity scores (from 5.5±1.5 to 3.9±1.4, P=0.012). However, fibrosis and hepatocyte ballooning scores remained unchanged.…”

Section: α-Glucosidase Inhibitorsmentioning

confidence: 91%

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

Kim

Lee

2020

Clin Mol Hepatol

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Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder and is associated with various metabolic diseases, including type 2 diabetes mellitus. There are no approved drugs for NAFLD, and the only approved treatment option is weight reduction. As insulin resistance plays an important role in the development of NAFLD, many anti-diabetic drugs have been evaluated for the treatment of NAFLD. Improvement of liver enzymes has been demonstrated by many anti-diabetic drugs, but histological assessment still remains insufficient. Pioglitazone could become the first-line therapy for T2DM patients with NAFLD, based on evidence of histological improvement in patients with biopsy-proven nonalcoholic steatohepatitis (NASH). Liraglutide, another promising alternative, is not yet recommended in patients with NAFLD/NASH due to limited evidence. Therefore, well-designed randomized controlled trials should be performed in the near future to demonstrate if and how anti-diabetic drugs can play a role in the treatment of NAFLD.

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Miglitol attenuates non‐alcoholic steatohepatitis in diabetic patients

Abstract: Miglitol appears to safely ameliorate NASH activity by attenuation of steatosis and lobular/portal inflammation. Appropriately powered controlled trials are warranted to validate our results.

Cited by 13 publications

References 20 publications

Clinical implications, diagnosis, and management of diabetes in patients with chronic liver diseases

Clinical implications, diagnosis, and management of diabetes in patients with chronic liver diseases

Tandem mass tag-based proteomics analysis of type 2 diabetes mellitus with non-alcoholic fatty liver disease in mice treated with acupuncture

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

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