Comparative efficacy of diabetes medications on liver enzymes and fat fraction in patients with nonalcoholic fatty liver disease: A network meta-analysis,, - 07/01/23
Editor: R. Poupon
Highlights |
• | NAFLD is considered as one of the most common causes of liver dysfunction. |
• | Three antidiabetic drugs (TZD, DPP-4is and GLP-1RAs) are effective in liver enzymes reduction. |
• | SGLT2is and GLP1RAs were superior to other diabetes medications in reducing liver fat fraction. |
Abstract |
Objectives |
This network meta-analysis (NMA) aimed to evaluate the relative rank-order of existing diabetes medications in patients with nonalcoholic fatty liver disease (NAFLD) with or without type 2 diabetes mellitus (T2DM).
Methods |
A systematic literature search was conducted using the Medline, Embase and Cochrane databases. Clinical trials comparing the efficacy of diabetes medications with other interventions, including lifestyle modification and placebo, in patients with NAFLD were included. The results from the NMA are presented as the weighted mean difference (WMD) of the continuous results and the corresponding 95% confidence intervals (95% CIs).
Results |
The articles presented the results of 49 trials involving 3,836 subjects published between 2013 and 2021. According to our results, thiazolidinedione (TZD) was ranked as the best diabetes medication in the reduction of alanine aminotransferase (ALT) (WMD = -10.10, 95% CI: -15.18, -5.01), followed by dipeptidyl peptidase-4 inhibitor (DPP4i) (WMD = -8.90, 95% CI: -14.41, -3.40). DPP4i also resulted in the greatest reduction in aspartate aminotransferase (AST) (WMD = -6.89, 95% CI: -11.72, -2.07). γ-Glutamyl transferase (γ-GT) reduction was highest in patients treated with glucagon-like peptide 1 receptor agonists (GLP1RAs) (WMD = -15.48, 95% CI: -30.93, -0.02). Ultimately, SGLT2is and GLP1RAs were superior to other diabetes medications or placebo in reducing liver fat fraction (LFF) (WMD = -6.09, 95% CI: -10.50, -1.68; WMD = -5.55, 95% CI: -10.40, -0.69, respectively).
Conclusion |
Diabetes medications, including TZD, DPP4i and GLP1RAs, were found to be suitable alternatives for liver enzyme reduction in the treatment of NAFLD patients. SGLT2is are considered the most effective therapies for lipid modulation in these patients.
Le texte complet de cet article est disponible en PDF.Keywords : Diabetes medications, Nonalcoholic fatty liver disease, Liver enzyme, Liver fat fraction, Network meta-analysis
Abbreviations : NAFLD, CT, MRI, MRI-PDFF, MRS, ALT, AST, γ-GT, LFF, DPP4i, GLP1RA, INS, LSM, MET, PLA, SGLT2i, SU, TZD, N/A
Plan
| ✰ | Author contributions: Zou CY conceived and wrote the manuscript; Sun Y contributed to the literature search; Zou CY and Liang J revised the final version of the manuscript. Zou CY and Sun Y contributed equally to this work. |
| ✰✰ | Supported by Social Development Project of the Xuzhou Municipal Science and Technology Bureau (KC21208, KC21231); Xuzhou Primary Research & Development Projects (KC21274) |
| ★ | PRISMA 2009 Checklist statement: The manuscript was prepared and revised according to the PRISMA 2009 Checklist. |
Vol 47 - N° 1
Article 102053- janvier 2023 Retour au numéro
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