Incretin mimetics as a novel therapeutic option for hepatic steatosis.
BACKGROUND
Fat accumulation in the liver or non-alcoholic fatty liver disease (NAFLD) is regarded as a key pathogenic factor and component of the metabolic syndrome. It was reported that administration of the incretin mimetic exenatide reversed hepatic steatosis in an obese mouse model. We had the opportunity to study the effect of additional exenatide administration on liver fat content in a patient with type 2 diabetes.


METHODS
A 59-year-old male with poorly controlled type 2 diabetes was treated with exenatide in addition to metformin monotherapy. Following 44 weeks of exenatide therapy, mean the liver fat measured by liver spectroscopy declined from 15.8% to 4.3%. This dramatic decrease in liver fat was accompanied by significant beneficial changes in several cardiovascular disease risk factors and improvement of all liver enzymes, in particular alanine aminotransferase, the most important marker of liver steatosis.


CONCLUSIONS
This case report suggests that the incretin mimetic exenatide decreases hepatic fat accumulation and may play a role in the future treatment of NAFLD, and the associated insulin resistance and cardiovascular risk factors in an ever-growing high-risk population.
Tushuizen
Maarten E
ME
Department of Endocrinology/Diabetes Centre, VU University Medical Centre, Amsterdam, The Netherlands. mnagaki@cc.gifu-u.ac.jp
Bunck
Mathijs C
MC
Pouwels
Petra J
PJ
van Waesberghe
Jan Hein T
JH
Diamant
Michaela
M
Heine
Robert J
RJ
D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000378:metabolism; D000077270:Exenatide; D005234:Fatty Liver / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D010455:Peptides / Q000627:therapeutic use*; D014688:Venoms / Q000627:therapeutic use*
D007004:Hypoglycemic Agents; D010455:Peptides; D014688:Venoms; D008687:Metformin; D000077270:Exenatide