title: Nonalcoholic Fatty liver: a possible new target for type 2 diabetes prevention and treatment.
abstract: Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder worldwide. Several lines of evidence have indicated a pathogenic role of insulin resistance, and a strong association with type 2 diabetes (T2MD) and metabolic syndrome. Importantly, NAFLD appears to enhance the risk for T2MD, as well as worsen glycemic control and cardiovascular disease in diabetic patients. In turn, T2MD may promote NAFLD progression. The opportunity to take into account NAFLD in T2MD prevention and care has stimulated several clinical studies in which antidiabetic drugs, such as metformin, thiazolidinediones, GLP-1 analogues and DPP-4 inhibitors have been evaluated in NAFLD patients. In this review, we provide an overview of preclinical and clinical evidences on the possible efficacy of antidiabetic drugs in NAFLD treatment. Overall, available data suggest that metformin has beneficial effects on body weight reduction and metabolic parameters, with uncertain effects on liver histology, while pioglitazone may improve liver histology. Few data, mostly preclinical, are available on DPP4 inhibitors and GLP-1 analogues. The heterogeneity of these studies and the small number of patients do not allow for firm conclusions about treatment guidelines, and further randomized, controlled studies are needed.
authors.affiliation: Endocrinology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro 88100, Italy. belfiore@unicz.it.
authors.forename: Barbara
authors.initials: B
authors.lastname: Fruci
authors.forename: Stefania
authors.initials: S
authors.lastname: Giuliano
authors.forename: Angela
authors.initials: A
authors.lastname: Mazza
authors.forename: Roberta
authors.initials: R
authors.lastname: Malaguarnera
authors.forename: Antonino
authors.initials: A
authors.lastname: Belfiore
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D018450:Disease Progression; D005234:Fatty Liver / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance / Q000235:genetics; D024821:Metabolic Syndrome / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D008687:Metformin / Q000627:therapeutic use; D065626:Non-alcoholic Fatty Liver Disease; D000077205:Pioglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use
chemical_list: D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D008687:Metformin; D000077205:Pioglitazone