Efficacy of alogliptin in preventing non-alcoholic fatty liver disease progression in patients with type 2 diabetes

Mashitani,Tsuyoshi; Noguchi,Ryuichi; Okura,Yasushi; Namisaki,Tadashi; Mitoro,Akira; Ishii,Hitoshi; Nakatani,Toshiya; Kikuchi,Eiryo; Moriyasu,Hiroto; Matsumoto,Masami; Sato,Shinya; An,Tatsuichi; Morita,Hiroshi; Aizawa,Sigeyuki; Tokuoka,Yasunori; Ishikawa,Masatoshi; Matsumura,Yoshinobu; Ohira,Hiromasa; Kogure,Atsuko; Noguchi,Kazuhiro; Yoshiji,Hitoshi

doi:10.3892/br.2016.569

Efficacy of alogliptin in preventing non-alcoholic fatty liver disease progression in patients with type 2 diabetes

Authors:
- Tsuyoshi Mashitani
- Ryuichi Noguchi
- Yasushi Okura
- Tadashi Namisaki
- Akira Mitoro
- Hitoshi Ishii
- Toshiya Nakatani
- Eiryo Kikuchi
- Hiroto Moriyasu
- Masami Matsumoto
- Shinya Sato
- Tatsuichi An
- Hiroshi Morita
- Sigeyuki Aizawa
- Yasunori Tokuoka
- Masatoshi Ishikawa
- Yoshinobu Matsumura
- Hiromasa Ohira
- Atsuko Kogure
- Kazuhiro Noguchi
- Hitoshi Yoshiji
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Affiliations: Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara 634‑8521, Japan, Department of Diabetology, Nara Medical University, Kashihara, Nara 634‑8521, Japan, Department of Gastroenterology, Nara Prefecture General Medical Center, Nara 631‑846, Japan, Department of Gastroenterology, Nara Prefectural Gojo Hospital, Gojo, Nara 637‑8511, Japan, Department of Gastroenterology, Belland General Hospital, Sakai, Osaka 599‑8247, Japan, Department of Internal Medicine, Takamiya Hospital, Tenri, Nara 632‑0052, Japan, Department of Gastroenterology, Nara Prefecture Western Medical Center, Nara 636‑0802, Japan, Department of Internal Medicine, Kokuho Chuo Hospital, Nara 636‑0302, Japan, Department of Gastroenterology, Ishinkai Yao General Hospital, Yao, Osaka 581‑0036, Japan, Department of Gastroenterology and Rheumatology, School of Medicine, Fukushima Medical University, Fukushima 960‑1295, Japan, Department of Gastroenterology, Fujita General Hospital, Fukusima 969-1793, Japan
Published online on: January 7, 2016 https://doi.org/10.3892/br.2016.569
Pages: 183-187

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Abstract

Non-alcoholic fatty liver disease (NAFLD) represents one of the most common causes of chronic liver disease worldwide and is characterized by chronic liver inflammation and fibrosis leading to cirrhosis and increased risk of liver cancer in a proportion of patients. Effective anti-fibrotic agents have yet to be approved for the treatment of NAFLD. The present study aimed to evaluate the efficacy of dipeptidyl peptidase 4 inhibitors (DPP4-I) in the prevention of NAFLD progression in NAFLD patients with type 2 diabetes. The study was a single arm, multi-centre, non-randomised study of NAFLD patients with type 2 diabetes. NAFLD was diagnosed according to ultrasonographic findings. All the patients received 25 mg/day of alogliptin for 12 months. The efficacy of alogliptin in preventing NAFLD progression was assessed using overall NAFIC scores [non-alcoholic steatohepatitis (NASH), ferritin, insulin and type IV collagen 7S] and individual component scores according to baseline haemoglobin A1c (HbA1c) levels. Of the 39 patients enrolled in the study, 16 patients (40.3%) had NAFIC scores >2 points, indicating the presence of NASH. NAFIC scores markedly decreased following 12 months of alogliptin administration, but remained >2 points in 10 patients, indicating that NASH may have persisted in these patients. The relative risks for persistent NASH were 4.92 (95% confidence interval, 0.61‑40.0) in the highest HbA1c tertile group compared with those in the lowest group. However, no statistically significant linear trend was observed across all HbA1c categories (P=0.145). DPP4-I may have efficacy against NAFLD progression in patients with type 2 diabetes with relatively lower HbA1c levels. DPP4-I may represent a potential new therapeutic strategy for the prevention of disease progression in NAFLD patients with type 2 diabetes.

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