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Gliptin therapy reduces hepatic and myocardial fat in type 2 diabetic patients
Author(s) -
KosiTrebotic Lana,
Thomas Anita,
Harreiter Jürgen,
Chmelik Marek,
Trattnig Siegfried,
KautzkyWiller Alexandra
Publication year - 2017
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12817
Subject(s) - medicine , metformin , diabetes mellitus , endocrinology , type 2 diabetes , cirrhosis , basal (medicine) , gastroenterology , waist , fatty liver , body mass index , disease
Background Increased hepatic fat and cardiac fat are common in patients with type 2 diabetes mellitus (T2 DM ) and are associated with a greater risk of liver fibrosis and cardiovascular ( CV ) events. Sex‐specific differences of dipeptidyl peptidase‐four ( DPP ‐4) inhibitor effects on hepatic ( HCL ) and myocardial fat content ( MYCL ) have not yet been evaluated. Method Forty‐one T2 DM patients (20 male, 21 female) received a gliptin add‐on therapy if HbA1c goals were not reached under metformin monotherapy. They underwent cardiac and liver magnetic resonance tomography and spectroscopy before and 6 months after therapy initiation. Plasma samples were analysed for the growth differentiation factor 15 ( GDF ‐15), a novel marker for cardiovascular risk. Results Thirty‐eight patients on gliptin therapy completed the study. We observed a positive correlation between MYCL and HCL before therapy ( R = 0·41, P = 0·05). After 6 months of therapy, we noticed a significant weight reduction in women only ( P = 0·02) whereas waist circumference decreased similarly in both sexes. HbA1c sunk significantly in both sexes ( P = 0·002). HCL decreased significantly ( P = 0·0004), with women featuring higher basal HCL ( P < 0·05). MYCL decreased in women only ( P = 0·01) and GDF ‐15 comparably in both sexes ( P < 0·05). Conclusions 6 months of DPP ‐4‐therapy led to a significant overall decrease in HCL and body weight such as a reduction of MYCL only in women. This preliminary data set could implicate that gliptin may be a feasible therapy option in fatty liver patients with diabetes potentially including positive effects on cardiovascular function particularly in women.