Additional benefits of type 2 diabetes treatment found for non-alcoholic fatty liver disease patients
A type 2 diabetes treatment has been found to also have 'off-label' benefits for glucose control in the liver and in fatty cells known as adipose.1 Presented at The International Liver Congress 2016 in Barcelona, Spain, today, the study shows that exenatide, a treatment that targets the pancreas to improve glucose absorption, enhances glucose uptake and reduces insulin resistance in the liver and in adipose tissue.
Non-alcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in the liver. In some cases this accumulation of fat can cause inflammation of the liver and eventually lead to permanent scarring (cirrhosis), which can seriously impair the liver's ability to function. NAFLD is closely associated with obesity and diabetes and the consequences of the condition can be grave, representing a major global public health problem.2 Two large European studies reported NAFLD prevalence rates of between approximately 43% and 70% in adults with type 2 diabetes.3
"There has been much discussion around the benefit of using injectable diabetes treatments, such as exenatide, on other tissues than the pancreas to improve glucose control," said Dr Amailia Gastaldelli, Institute of Clinical Physiology, CNR, Pisa, Italy, University of Texas Health Science Center, San Antonio, USA, and lead author of the study. "This is why we set out to evaluate the effects of exenatide on the liver and adipose tissue; to better understand the benefits this treatment could offer to a wider group of patients."
Male participants (n=15) with a fatty liver index score of >30 (a classification system that ranges from 0 to 100)4 were tested on two occasions. Those with a score <30 are deemed to have a negative likelihood of having fatty liver. Exenatide or placebo was injected 30 minutes before an oral glucose test in the double blinded study. The test measured glucose uptake in liver tissue and abdominal adipose tissue glucose uptake.
The results showed that acute exenatide administration (5mcg) decreased glucose production and insulin resistance (p=0.02) in the liver tissue when blood sugars were low. The treatment also improved liver tissue uptake of glucose when it is eaten (p=0.039). Furthermore, exenatide decreased insulin resistance in fatty adipose tissue (p=0.009).
"This interesting study shows promising findings for the many people around the world who suffer from non-alcoholic fatty liver disease," says Professor Tom Hemming Karlsen, EASL Vice-Secretary. "The authors have succeeded in identifying an existing treatment that can improve liver metabolism, which is an important step forward for the hepatology community."
1 Science Daily. Reference terms. Adipose Tissue. Available from: www.sciencedaily.com/terms/adipose_tissue.htm. Last accessed: March 2016.
2 World Gastroenterology Organisation Global Guidelines. Non-alcoholic Fatty Liver Disease and Non-alcoholic Steatohepatitis. Available from: www.worldgastroenterology.org/ … NAFLD_Final_long.pdf. Last accessed: March 2016.
3 European Association for the Study of the Liver. The Burden of Liver Disease in Europe. Available from: www.easl.eu/medias/EASLimg/Dis … 845caec619f_file.pdf. Last accessed: March 2016.
4 Bio Med Central. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. Available from: bmcgastroenterol.biomedcentral … .1186/1471-230X-6-33. Last accessed March 2016.