Combined effects of synbiotic and sitagliptin versus sitagliptin alone in patients with nonalcoholic fatty liver disease
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Background/Aims: Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases in recent years. The aim of this study was to evaluate the effects of sitagliptin with and without a synbiotic supplement in the treatment of patients with NAFLD. Methods: In total, 138 NAFLD patients aged 18-60 years were enrolled in the study. Patients were randomized to one of the following treatments for 16 weeks: Group I (n=68), sitagliptin 50 mg daily plus placebo (one capsule per day) or group II (n=70) sitagliptin 50 mg daily plus synbiotic (one capsule per day). Changes in fasting blood glucose (FBS), liver enzymes, lipid profile, and body mass index were compared between the groups. Results: The mean change in FBS with sitagliptin-placebo from baseline was -10.47±5.77 mg/dL, and that with sitagliptin-synbiotic was -13.52±4.16 mg/dL. There was a significant difference between the groups (P<0.001). The mean change in cholesterol (Chol) was -8.34±28.83 mg/dL with sitagliptin-placebo and -21.25±15.50 mg/dL with sitagliptinsynbiotic. There was a significant difference between the two groups (P=0.029). The administration of sitagliptin-placebo induced an increase of 6.13±27.04 mg/dL in low density lipoprotein (LDL), whereas sitagliptin-synbiotic induced a decrease of 14.92±15.85 mg/dL in LDL. A significant difference was observed between the two groups (P<0.001). On the other hand, in the sitagliptin-synbiotic group, there was significant improvement in aspartate aminotransferase (AST) level compared to the sitagliptin-placebo group (P=0.018). Conclusions: Sitagliptin-synbiotic produced greater improvement in FBS, AST, Chol, and LDL compared to sitagliptin alone in patients with NAFLD.
Abstract
Background/Aims: Non-alcoholic fatty liver disease (NAFLD) is one of the most prevalent chronic liver diseases in recent years. The aim of this study was to evaluate the effects of sitagliptin with and without a synbiotic supplement in the treatment of patients with NAFLD. Methods: In total, 138 NAFLD patients aged 18-60 years were enrolled in the study. Patients were randomized to one of the following treatments for 16 weeks: Group I (n=68), sitagliptin 50 mg daily plus placebo (one capsule per day) or group II (n=70) sitagliptin 50 mg daily plus synbiotic (one capsule per day). Changes in fasting blood glucose (FBS), liver enzymes, lipid profile, and body mass index were compared between the groups. Results: The mean change in FBS with sitagliptin-placebo from baseline was -10.47±5.77 mg/dL, and that with sitagliptin-synbiotic was -13.52±4.16 mg/dL. There was a significant difference between the groups (P<0.001). The mean change in cholesterol (Chol) was -8.34±28.83 mg/dL with sitagliptin-placebo and -21.25±15.50 mg/dL with sitagliptinsynbiotic. There was a significant difference between the two groups (P=0.029). The administration of sitagliptin-placebo induced an increase of 6.13±27.04 mg/dL in low density lipoprotein (LDL), whereas sitagliptin-synbiotic induced a decrease of 14.92±15.85 mg/dL in LDL. A significant difference was observed between the two groups (P<0.001). On the other hand, in the sitagliptin-synbiotic group, there was significant improvement in aspartate aminotransferase (AST) level compared to the sitagliptin-placebo group (P=0.018). Conclusions: Sitagliptin-synbiotic produced greater improvement in FBS, AST, Chol, and LDL compared to sitagliptin alone in patients with NAFLD.
참고문헌 (42)
- Vuppalanchi R, "Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: Selected practical issues in their evaluation and management", Hepatology, 49, pp.306~317 (2009)[DOI]
- Watanabe S, "Liver diseases and metabolic syndrome", J Gastroenterol, 43, pp.509~518 (2008)[DOI]
- Jou J, "Mechanisms of disease progression in nonalcoholic fatty liver disease", Semin Liver Dis, 28, pp.370~379 (2008)[DOI]
- Harrison SA, "The natural history of nonalcoholic fatty liver disease: a clinical histopathological study", Am J Gastroenterol, 98, pp.2042~2047 (2003)[DOI]
- Adams LA, "The natural history of nonalcoholic fatty liver disease: a population-based cohort study", Gastroenterology, 129, pp.113~121 (2005)[DOI]
- Ekstedt M, "Long-term follow-up of patients with NAFLD and elevated liver enzymes", Hepatology, 44, pp.865~873 (2006)[DOI]
- Baffy G, "Hepatocellular carcinoma in non-alcoholic fatty liver disease: an emerging menace", J Hepatol, 56, pp.1384~1391 (2012)[DOI]
- Kim D, "Association between noninvasive fibrosis markers and mortality among adults with nonalcoholic fatty liver disease in the United States", Hepatology, 57, pp.1357~1365 (2013)[DOI]
- Buss C, "Probiotics and synbiotics may improve liver aminotransferases levels in nonalcoholic fatty liver disease patients", Ann Hepatol, 13, pp.482~488 (2014)
- Rinella ME, "Nonalcoholic fatty liver disease: a systematic review", JAMA, 313, pp.2263~2273 (2015)[DOI]
- Bhatt HB, "Fatty liver disease in diabetes mellitus", Hepatobiliary Surg Nutr, 4, pp.101~108 (2015)
- Saponaro C, "Nonalcoholic fatty liver disease and type 2 diabetes: common pathophysiologic mechanisms", Curr Diab Rep, 15, pp.607~ (2015)
- Jamali R, "Non-alcoholic fatty liver disease", KAUMS Journal (Feyz), 14, pp.169~179 (2010)
- Ohki T, "The effectiveness of liraglutide in nonalcoholic fatty liver disease patients with type 2 diabetes mellitus compared to sitagliptin and pioglitazone", Scientific World Journal, 2012, pp.496453~ (2012)
- Yilmaz Y, "Effects of sitagliptin in diabetic patients with nonalcoholic steatohepatitis", Acta Gastroenterol Belg, 75, pp.240~244 (2012)
- Shavakhi A, "Effect of a probiotic and metformin on liver aminotransferases in non-alcoholic steatohepatitis: a double blind randomized clinical trial", Int J Prev Med, 4, pp.531~537 (2013)
- Younossi ZM, "Changes in the prevalence of the most common causes of chronic liver diseases in the United States from 1988 to 2008", Clin Gastroenterol Hepatol, 9, pp.524~530 (2011)[DOI]
- Targher G, "Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease", N Engl J Med, 363, pp.1341~1350 (2010)[DOI]
- Targher G, "Increased risk of cardiovascular disease in non-alcoholic fatty liver disease: causal effect or epiphenomenon?", Diabetologia, 51, pp.1947~1953 (2008)[DOI]
- Wong VW, "Treatment of nonalcoholic steatohepatitis with probiotics. A proofof-concept study", Ann Hepatol, 12, pp.256~262 (2013)
- "The Practical Guide: Identification, evaluation, and treatment of overweight and obesity in adults" (2000)
- Lonardo A, "NAFLD: is there anything new under the sun?", Int J Mol Sci, 18 (2017)
- Barb D, "Pharmacological management of nonalcoholic fatty liver disease", Metabolism, 65, pp.1183~1195 (2016)[DOI]
- Shakeri H, "Consumption of synbiotic bread decreases triacylglycerol and VLDL levels while increasing HDL levels in serum from patients with type-2 diabetes", Lipids, 49, pp.695~701 (2014)[DOI]
- Barengolts E, "Gut microbiota, prebiotics, probiotics, and synbiotics in management of obesity and prediabetes: review of randomized controlled trials", Endocr Pract, 22, pp.1224~1234 (2016)[DOI]
- Al-Salami H, "Probiotic treatment reduces blood glucose levels and increases systemic absorption of gliclazide in diabetic rats", Eur J Drug Metab Pharmacokinet, 33, pp.101~106 (2008)[DOI]
- Goh GBB, "Pharmacologic management of non-alcoholic fatty liver disease", Adv Pharmacoepidemiol Drug Saf, 3, pp.157~ (2014)
- Olaywi M, "Novel anti-diabetic agents in non-alcoholic fatty liver disease: a mini-review", Hepatobiliary Pancreat Dis Int, 12, pp.584~588 (2013)[DOI]
- Hardy T, "Nonalcoholic fatty liver disease: new treatments", Curr Opin Gastroenterol, 31, pp.175~183 (2015)[DOI]
- Koren S, "The effect of sitagliptin versus glibenclamide on arterial stiffness, blood pressure, lipids, and inflammation in type 2 diabetes mellitus patients", Diabetes Technol Ther, 14, pp.561~567 (2012)[DOI]
- Monami M, "DPP-4 inhibitors and lipids: systematic review and meta-analysis", Adv Ther, 29, pp.14~25 (2012)[DOI]
- Duvnjak L, "Dipeptidyl peptidase-4 inhibitors improve arterial stiffness, blood pressure, lipid profile and inflammation parameters in patients with type 2 diabetes mellitus", Diabetol Metab Syndr, 8, pp.26~ (2016)[DOI]
- Wasada T, "Effect of gastric inhibitory polypeptide on plasma levels of chylomicron triglycerides in dogs", J Clin Invest, 68, pp.1106~1107 (1981)[DOI]
- Kim SJ, "Activation of lipoprotein lipase by glucose-dependent insulinotropic polypeptide in adipocytes. A role for a protein kinase B, LKB1, and AMP-activated protein kinase cascade", J Biol Chem, 282, pp.8557~8567 (2007)[DOI]
- Meier JJ, "Glucagon-like peptide 1 abolishes the postprandial rise in triglyceride concentrations and lowers levels of non-esterified fatty acids in humans", Diabetologia, 49, pp.452~458 (2006)[DOI]
- Liong MT, "Effects of a synbiotic containing Lactobacillus acidophilus ATCC 4962 on plasma lipid profiles and morphology of erythrocytes in hypercholesterolaemic pigs on highand low-fat diets", Br J Nutr, 98, pp.736~744 (2007)
- Roselino MN, "A potential synbiotic product improves the lipid profile of diabetic rats", Lipids Health Dis, 11, pp.114~ (2012)[DOI]
- Beserra BT, "A systematic review and meta-analysis of the prebiotics and synbiotics effects on glycaemia, insulin concentrations and lipid parameters in adult patients with overweight or obesity", Clin Nutr, 34, pp.845~858 (2015)[DOI]
- Ooi LG, "Cholesterol-lowering effects of probiotics and prebiotics: a review of in vivo and in vitro findings", Int J Mol Sci, 11, pp.2499~2522 (2010)[DOI]
- Lirussi F, "Probiotics for nonalcoholic fatty liver disease and", or steatohepatitis, 2007, pp.(1), ~
- Abenavoli L, "Probiotics in non-alcoholic fatty liver disease: which and when", Ann Hepatol, 12, pp.357~363 (2013)
- Eslamparast T, "Synbiotic supplementation in nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled pilot study", Am J Clin Nutr, 99, pp.535~542 (2014)[DOI]