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Metformin, liraglutide improve liver function in type 2 diabetes, NAFLD
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Metformin and liraglutide resulted in greater liver function improvements compared with gliclazide in adults with type 2 diabetes and nonalcoholic fatty liver disease, according to findings from China.
Da-Long Zhu, MD, PhD, of the department of endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School in China, and colleagues evaluated 87 adults (mean age, 47.15 years) with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) randomly assigned to liraglutide, gliclazide or metformin for 24 weeks to determine the effectiveness of each on HbA1c levels, intrahepatic fat content and liver function.
No difference was found among the three groups for baseline intrahepatic fat. Intrahepatic fat content decreased after 24 weeks in all three groups (P < .001 for all treatment groups). Compared with gliclazide treatment, liraglutide resulted in a greater reduction in intrahepatic fat content (P = .001). Liver function also improved in all treatment groups after the reductions in intrahepatic fat, but liver function improvements reached statistical significance in only the liraglutide and metformin groups.
All three treatment groups experienced decreases in body weight, but statistical significance was reached in only the liraglutide (P < .001) and metformin groups (P = .001). BMI and waist circumference significantly decreased in the liraglutide and metformin groups, but not in the gliclazide group.
All three treatment groups had lower blood glucose levels from baseline after 24 weeks of treatment (P < .001 for all). HbA1c significantly decreased in all three groups by weeks 12 and 24; however, HbA1c remained higher in the gliclazide group compared with the liraglutide group at 12 weeks (P = .001) and 24 weeks (P = .002) and the metformin group at 24 weeks (P = .014).
Before and after adjustment for BMI, changes in intrahepatic fat were significantly correlated with weight reduction, changes in triglycerides and aminotransferase levels.
“As expected, intrahepatic fat content was reduced by the GLP-1 analogue, liraglutide, as well as the biguanide, metformin, both of which have been shown to be intrahepatic fat-lowering antidiabetic drugs,” the researchers wrote. “However, of importance is the finding that gliclazide, a sulfonylurea, also lowered intrahepatic fat content. Generally, intrahepatic fat content is thought to be unchanged by gliclazide.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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