title: DPP-4 inhibitors improve liver dysfunction in type 2 diabetes mellitus.
abstract: BACKGROUND
  Dipeptidyl peptidase-4 (DPP-4) inhibitors might have pleiotropic effects because receptors for incretin exist in various tissues, including liver. We examined whether DPP-4 inhibitors affect liver function in patients with type 2 diabetes.
  
  
  METHODS
  A retrospective review of 459 patients with type 2 diabetes who were prescribed DPP-4 inhibitors was performed. After exclusion of patients with hepatitis B or C, steroid use, and other diseases that might affect liver function and diabetes status, 224 patients were included in the analysis.
  
  
  RESULTS
  Forty-four patients (19.6%) with liver injury defined by aspartate transaminase (AST) or alanine transaminase (ALT) over the normal level of 40 U/L. In the patients with liver injury, AST and ALT were significantly decreased after 6 months from the first date of DPP-4 prescription, with mean changes of -6.2 U/L [95% confidence interval (CI) -10.9 to -1.4, p=0.012] and of -11.9 U/L (95%CI -19.5 to -4.2, p=0.003), respectively. Percent changes in AST were significantly and negatively correlated with baseline AST and ALT (r=-0.27, p<0.001 and r=-0.23, p=0.002, respectively), and percent changes in ALT were also negatively correlated with them (r=-0.23, p=0.001 and r=-0.27, p<0.001, respectively).
  
  
  CONCLUSIONS
  DPP-4 inhibitors improved liver dysfunction in patients with type 2 diabetes.
authors.affiliation: Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Kanazawa
authors.affiliation: Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Tanaka
authors.affiliation: Department of Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan.
authors.forename: Toshitsugu
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D000410:Alanine Transaminase; D001219:Aspartate Aminotransferases; D054873:Dipeptidyl-Peptidase IV Inhibitors; D006442:Glycated Hemoglobin