Effect of exenatide therapy on hepatic fat quantity and hepatic biomarkers in type 2 diabetic patients

Abstract

Nonalcoholic fatty liver disease (NAFLD) is one of the most common liver disease characterized by hepatic fat accumulation. The aim of this study was to to evaluate the effect of exenatide therapy on NAFLD markers, namely concentrations of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALK), γ-glutamyltransferase (GGT), and hepatic fat in type 2 diabetic patients. Study included 102 patients with type 2 diabetes without clinical evidence of cirrhosis or other causes of chronic liver disease. Thirty-five were on stabile doses of oral hypoglycemic agents (OHA) metformin or/and sulphonylurea and 67 starting exenatide therapy. Fatty liver index (FLI) is calculated using an equation including body mass index (BMI), waist circumference, tryglicerides (TG) and GGT. We assessed changes in NAFLD markers, FLI, BMI, waist circumference, and HbA1c levels in two T2DM groups of patients, one treated with exenatide and the other treated with metformin or/and sulphonylurea. Patients treated with exenatide had significantly lower levels of AST (24 vs 23 U/L), ALT (36 vs 27 U/L), ALK (83 vs 73 U/L), GGT (38 vs 23 U/L), FLI (24 vs 9), BMI (39 vs 35), waist circumference (119 vs 111) and HbA1c (8.4 vs 7.3) after 24 weeks of therapy. These differences in NAFLD markers and FLI were independent of BMI, waist circumference or HbA1c. No significant differences in NAFLD markers and FLI were observed in group of patients treated with metformin or/and sulphonylurea. In the exenatide group there was no statistical significant difference in the between group comparrison concidering exenatide concomitant therapy in the observed laboratory measurements. The median change in FLI for group treated with 5µg of exenatede was -13.6 and for group treated with 10µg of exenatide was -6.5. Introduction of exenatide therapy to T2DM patients seems to have positive pleiotropic effect in liver, especially in hepatic fat metabolism.