Effect of sitagliptin on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis patients: a 1-year randomized control trial

Shahinul Alam,1 Jhumur Ghosh,1 Golam Mustafa,1 Mohammad Kamal,2 Nooruddin Ahmad1 1Department of Hepatology, 2Department of Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh Background/purpose: Dipeptidyl peptidase 4 (DPP-4) expression is directly associated with hepatic lipog...

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Autores principales:	Alam S, Ghosh J, Mustafa G, Kamal M, Ahmad N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Fatty liver NASH Sitagliptin NAS Fibrosis steatosis ballooning histological activity. Diseases of the digestive system. Gastroenterology RC799-869
Acceso en línea:	https://doaj.org/article/9ff9b0975d6c449f8e8f9a1b7e469748
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spelling	oai:doaj.org-article:9ff9b0975d6c449f8e8f9a1b7e4697482021-12-02T04:17:40ZEffect of sitagliptin on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis patients: a 1-year randomized control trial1179-1535https://doaj.org/article/9ff9b0975d6c449f8e8f9a1b7e4697482018-04-01T00:00:00Zhttps://www.dovepress.com/effect-of-sitagliptin-on-hepatic-histological-activity-and-fibrosis-of-peer-reviewed-article-HMERhttps://doaj.org/toc/1179-1535Shahinul Alam,1 Jhumur Ghosh,1 Golam Mustafa,1 Mohammad Kamal,2 Nooruddin Ahmad1 1Department of Hepatology, 2Department of Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh Background/purpose: Dipeptidyl peptidase 4 (DPP-4) expression is directly associated with hepatic lipogenesis and liver injury in nonalcoholic steatohepatitis (NASH). This study has been designed to elucidate the histological improvement of NASH with the DPP-4 inhibitor sitagliptin. Materials and methods: In this open-label randomized control trial, paired liver biopsy was taken from 40 NASH patients. Sitagliptin 100 mg was given once daily to the SL group and no sitagliptin was given to the L group for 1 year. Patients from both groups were encouraged to exercise moderately and advised to avoid saturated fat, excessive sugar, soft drinks, fast food, and refined carbohydrates to reduce weight. Results: Steatosis improved in the SL group (from 2.3±0.6 to 1.2±0.8; P=0.000) and the L group (from 2.1±0.6 to 1.6±0.9; P=0.008), ballooning decreased from 1.8±0.6 to 1.3±06 (P=0.002) in the SL group, but not in the L group. Nonalcoholic fatty liver disease activity score (NAS) attenuated in both groups: the SL group (from 5.8±0.9 to 3.9±1.4; P=0.000) and the L group (from 5.3±0.6 to 4.6±1.2; P=0.009). NAS improvement was much higher in the SL group (1.9±1.4) than in the L group (0.7±1.1) (P=0.006), with NAS improving by ≥2 in 13 patients from the SL group and five patients from the L group (P=0.01). Improvement was irrespective of diabetes. Regression analysis explored that sitagliptin had odds of 6.38 and weight reduction had odds of 4.51 for NAS reduction. Conclusion: Sitagliptin 100 mg once daily for 1 year ameliorates NAS by improving steatosis and ballooning, irrespective of diabetes. Sitagliptin has stronger efficacy than that of weight reduction. Keywords: fatty liver, NASH, sitagliptin, NAS, fibrosis, steatosis, ballooning, histological activityAlam SGhosh JMustafa GKamal MAhmad NDove Medical PressarticleFatty liverNASHSitagliptinNASFibrosissteatosisballooninghistological activity.Diseases of the digestive system. GastroenterologyRC799-869ENHepatic Medicine: Evidence and Research, Vol Volume 10, Pp 23-31 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Fatty liver NASH Sitagliptin NAS Fibrosis steatosis ballooning histological activity. Diseases of the digestive system. Gastroenterology RC799-869
spellingShingle	Fatty liver NASH Sitagliptin NAS Fibrosis steatosis ballooning histological activity. Diseases of the digestive system. Gastroenterology RC799-869 Alam S Ghosh J Mustafa G Kamal M Ahmad N Effect of sitagliptin on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis patients: a 1-year randomized control trial
description	Shahinul Alam,1 Jhumur Ghosh,1 Golam Mustafa,1 Mohammad Kamal,2 Nooruddin Ahmad1 1Department of Hepatology, 2Department of Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh Background/purpose: Dipeptidyl peptidase 4 (DPP-4) expression is directly associated with hepatic lipogenesis and liver injury in nonalcoholic steatohepatitis (NASH). This study has been designed to elucidate the histological improvement of NASH with the DPP-4 inhibitor sitagliptin. Materials and methods: In this open-label randomized control trial, paired liver biopsy was taken from 40 NASH patients. Sitagliptin 100 mg was given once daily to the SL group and no sitagliptin was given to the L group for 1 year. Patients from both groups were encouraged to exercise moderately and advised to avoid saturated fat, excessive sugar, soft drinks, fast food, and refined carbohydrates to reduce weight. Results: Steatosis improved in the SL group (from 2.3±0.6 to 1.2±0.8; P=0.000) and the L group (from 2.1±0.6 to 1.6±0.9; P=0.008), ballooning decreased from 1.8±0.6 to 1.3±06 (P=0.002) in the SL group, but not in the L group. Nonalcoholic fatty liver disease activity score (NAS) attenuated in both groups: the SL group (from 5.8±0.9 to 3.9±1.4; P=0.000) and the L group (from 5.3±0.6 to 4.6±1.2; P=0.009). NAS improvement was much higher in the SL group (1.9±1.4) than in the L group (0.7±1.1) (P=0.006), with NAS improving by ≥2 in 13 patients from the SL group and five patients from the L group (P=0.01). Improvement was irrespective of diabetes. Regression analysis explored that sitagliptin had odds of 6.38 and weight reduction had odds of 4.51 for NAS reduction. Conclusion: Sitagliptin 100 mg once daily for 1 year ameliorates NAS by improving steatosis and ballooning, irrespective of diabetes. Sitagliptin has stronger efficacy than that of weight reduction. Keywords: fatty liver, NASH, sitagliptin, NAS, fibrosis, steatosis, ballooning, histological activity
format	article
author	Alam S Ghosh J Mustafa G Kamal M Ahmad N
author_facet	Alam S Ghosh J Mustafa G Kamal M Ahmad N
author_sort	Alam S
title	Effect of sitagliptin on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis patients: a 1-year randomized control trial
title_short	Effect of sitagliptin on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis patients: a 1-year randomized control trial
title_full	Effect of sitagliptin on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis patients: a 1-year randomized control trial
title_fullStr	Effect of sitagliptin on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis patients: a 1-year randomized control trial
title_full_unstemmed	Effect of sitagliptin on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis patients: a 1-year randomized control trial
title_sort	effect of sitagliptin on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis patients: a 1-year randomized control trial
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/9ff9b0975d6c449f8e8f9a1b7e469748
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Effect of sitagliptin on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis patients: a 1-year randomized control trial

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