title: Incretin based therapies: a novel treatment approach for non-alcoholic fatty liver disease.
abstract: Non-alcoholic fatty liver disease is considered a hepatic manifestation of metabolic syndrome (MS). The current treatment of non-alcoholic fatty liver disease (NAFLD) principally includes amelioration of MS components by lifestyle modifications but the lack of success in their implementation and sustainment arises the need for effective pharmacological agent in fatty liver treatment. Incretins are gut derived hormones secreted into the circulation in response to nutrient ingestion that enhances glucose-stimulated insulin secretion. Glucagon-like peptide-1 (GLP-1) is the most important incretin. Its receptor agonist and inhibitors of dipeptidyl peptidase-4 (DPP-4) are used in treatment of type 2 diabetes mellitus. DPP-4 serum activity and hepatic expression are shown to be elevated in several hepatic diseases. There are several experimental and clinical trials exploring the efficacy of incretin based therapies in NAFLD treatment. They suggest that GLP-1 analogues might have beneficial effect on hepatic steatosis acting as insulin sensitizers and directly by stimulating GLP-1 receptors expressed on hepatocytes. The use of DPP-4 inhibitors also results in hepatic fat reduction but the mechanism of action remains unclear. There is growing evidence that incretin based therapies have beneficial effects on hepatocytes, however further study analysis are needed to assess the long term effect of incretin based therapies on NAFLD.
authors: Kristina Blaslov, Tomislav Bulum, Karin Zibar, Lea Duvnjak, Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
authors: Kristina
authors: K
authors: Blaslov
authors: Kristina Blaslov, Tomislav Bulum, Karin Zibar, Lea Duvnjak, Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
authors: Tomislav
authors: T
authors: Bulum
authors: Kristina Blaslov, Tomislav Bulum, Karin Zibar, Lea Duvnjak, Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
authors: Karin
authors: K
authors: Zibar
authors: Kristina Blaslov, Tomislav Bulum, Karin Zibar, Lea Duvnjak, Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
authors: Lea
authors: L
authors: Duvnjak
mesh_terms: D000818:Animals; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D000067757:Glucagon-Like Peptide-1 Receptor; D006801:Humans; D054795:Incretins / Q000627:therapeutic use*; D008099:Liver / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D065626:Non-alcoholic Fatty Liver Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D018027:Receptors, Glucagon / Q000819:agonists / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; C000593833:GLP1R protein, human; D000067757:Glucagon-Like Peptide-1 Receptor; D054795:Incretins; D018027:Receptors, Glucagon
keywords: Dipeptidyl peptidase-4; Glucagon-like peptide-1; Insulin resistance; Metabolic syndrome; Non-alcoholic fatty liver disease