Non-Alcoholic Fatty Liver Disease Adversely Affects the Glycemic Control Afforded by Sitagliptin

Background/Aims: Recently, high serum DPP-4 activity was found in patients with NAFLD. Therefore, the possibility of NAFLD adversely influencing the therapeutic effect afforded by DPP-4 inhibitors in type 2 diabetic patients was suggested. Methodology: A total of 20 type 2 DM patients with NAFLD and 85 type 2 DM patients without NAFLD were enrolled in the present study. The patients were administered sitagliptin at the dose of 50 mg/day for 12 weeks. Results: The change in HbA1c from the baseline following treatment with sitagliptin was -0.47% (4 weeks), -0.73% (8 weeks) and -0.88% (12 weeks) in the type 2 DM patients with NAFLD and -0.26% (4 weeks), -0.41% (8 weeks) and -0.49% (12 weeks) in type 2 DM without NAFLD. The changes in the HbA1c from the baseline after sitagliptin treatment for 8 and 12 weeks were significantly greater in type 2 DM patients with NAFLD than in type 2 DM patients without NAFLD. Conclusions: The results of this study suggest that NAFLD might adversely affect the therapeutic effect afforded by sitagliptin treatment in patients with type 2 DM. NAFLD may be an independent predictor of the effect of sitagliptin in patients with type 2 DM.