title: Effects of Oral Antidiabetic Drugs on Changes in the Liver-to-Spleen Ratio on Computed Tomography and Inflammatory Biomarkers in Patients With Type 2 Diabetes and Nonalcoholic Fatty Liver Disease.
abstract: OBJECTIVE
  Oral antidiabetic drugs (OADs) such as pioglitazone and metformin have beneficial effects in patients with nonalcoholic steatohepatitis. We prospectively assessed the effects of OADs on nonalcoholic fatty liver disease (NAFLD) in 886 men with type 2 diabetes mellitus and in a murine model of NAFLD.
  
  
  METHODS
  Patients were randomized to receive pioglitazone, metformin, sitagliptin, or a non-OAD (control) for 6 months. All the patients received dietary and exercise guidance once a month during this study. Changes in the liver-to-spleen ratio on computed tomography (CT) and NAFLD-related parameters were measured from baseline to the end of treatment.
  
  
  RESULTS
  The liver/spleen ratio improved significantly in the pioglitazone and metformin groups compared with the control group (both P < 0.01), but not in the sitagliptin group (P = 0.73). The mean changes from baseline were -3.464 ± 10.156%, 19.236 ± 9.896%, 4.783 ± 1.467%, and 1.328 ± 0.802% in the control, pioglitazone, metformin, and sitagliptin groups, respectively. Multivariable analysis showed that the liver/spleen ratio was strongly correlated with high-sensitivity C-reactive protein concentration in the pioglitazone group (F = 9.973; P < 0.01) and abdominal visceral fat volume in the metformin group (F = 6.049; P < 0.05).
  
  
  CONCLUSIONS
  Pioglitazone elicited the greatest improvements in features of NAFLD in type 2 diabetes mellitus. (Trial Registration: www.isrctn.org/, ISRCTN33414972, http://www.isrctn.org/).
authors.affiliation: University of the Ryukyus, Graduate School of Medicine, Okinawa, Japan. Electronic address: kyabiku@med.u-ryukyu.ac.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Yabiku
authors.affiliation: Clinical Pharmacology and Therapeutics University of the Ryukyus School of Medicine, Okinawa, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Mutoh
authors.affiliation: Eucalia Okinawa Kanna Hospital, Internal Medicine, Ginoza, Okinawa, Japan.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Miyagi
authors.affiliation: Aizawa Hospital, Matsumoto, Nagano, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takasu
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000188:drug therapy*; D000077205:Pioglitazone; D000068900:Sitagliptin Phosphate / Q000008:administration & dosage; D013154:Spleen / Q000000981:diagnostic imaging; D045162:Thiazolidinediones / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D007004:Hypoglycemic Agents; D045162:Thiazolidinediones; D002097:C-Reactive Protein; D008687:Metformin; D000068900:Sitagliptin Phosphate; D000077205:Pioglitazone
keywords: CT; L/S ratio; NAFLD; OAD; T2DM