scholarly journals Testosterone deficiency and non-alcoholic fatty liver disease in men with type 2 diabetes mellitus

2020 ◽  
Vol 22 (6) ◽  
pp. 542-549 ◽  
Author(s):  
Irina A. Khripun ◽  
Sergey V. Vorobyev ◽  
Yanina Allahverdieva
Keyword(s):  
Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Fat ◽  
Alcoholic Fatty Liver ◽  
Type 2 Dm ◽  
Carbohydrate And Lipid Metabolism ◽  
Fat Fraction ◽  
Alcoholic Fatty Liver Disease

BACKGROUND: Current studies investigated diseases associated with testosterone (T) deficiency; however, data on the combination of non-alcoholic fatty liver disease (NAFLD) with hypogonadism and diabetes mellitus (DM) in men are extremely limited. AIMS: To evaluate the effects of hypogonadism on the formation and progression of NAFLD in men with type 2 DM. METHODS: The study included 90 men with type 2 DM [age 54 (4957) years]. Patients underwent clinical examinations, biochemical analysis (alanine aminotransferase (ALT), aspartate aminotransferase, gamma-glutamyl transpeptidase (GGTP), fasting glucose, immunoreactive insulin, HOMA index, HbA1c, lipid profile), immune enzyme analysis (luteinising hormone, total T, sex hormone binding globulin, resistin, adiponectin, leptin) and magnetic resonance imaging with liver fat fraction determination were performed. Patients were divided into two groups: 132 eugonadal patients and 258 men with newly diagnosed hypogonadism. RESULTS: Increased insulin resistance, hyperinsulinemia, hypertriglyceridemia were observed in men with hypogonadism compared to eugonadal patients. Along with biochemical signs of impaired liver function, such as an increase in liver enzyme concentrations of ALT by 24.5% (p = 0.02), GGTP by 60.5% (p = 0.001), de Rytis coefficient by 60.4% (p = 0.047), of men in the 2nd group, the liver fat fraction also increased, which together indicates NAFLD progression. The proton density of the liver fat fraction according to MRI was 4.12 [2.255.30] % in the 1st group and 10.30 [7.78; 14.44] % in the 2nd group (p=0.001). This was accompanied by an increase in fat production of resistin by 2 times and leptin by 12 times (p 0.001) in patients of group 2 compared to 1. CONCLUSIONS: The combination of type 2 DM with hypogonadism in men leads not only to deterioration of carbohydrate and lipid metabolism but also to disturbance of liver function: increased ALT, GGTP concentrations and liver fat. Increased secretion of leptin and resistin in the adipose tissue is assumed to be a pathogenetically associated with the development of carbohydrate and lipid metabolism disorders, NAFLD and T deficiency.

scholarly journals Effect of Empagliflozin on Liver Function in type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Trials

2020 ◽  
Author(s):  
Davoud Roostaei
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Liver Fat ◽  
Alcoholic Fatty Liver ◽  
Significant Difference ◽  
Alcoholic Fatty Liver Disease

Abstract Background Many reports are indicating the blood sugar-lowering potential of Empagliflozin in type 2 diabetes mellitus and its anti-lipogenesis effects in the liver, as studied in mice models; while few clinical trials have evaluated its effect on liver fat content and liver function. Objectives This study aimed to evaluate the effect of Empagliflozin on the treatment of non‐alcoholic fatty liver disease in type 2 diabetes mellitus patients.Search methods Scopus, Cochran Library, PubMed, and Web of Science databases were searched from 1990 to 2020 together with reference checking and citation searching to identify additional studies. Selection criteria Inclusion criteria for studies were the evaluation of patients with non‐alcoholic fatty liver disease and type 2 diabetes being treated with Empagliflozin for 24 weeks. Our interest outcomes were Liver fat, ALT, and AST. Data analysis Random effect size model was used for pooling data to calculate mean differences in RevMan Version 5.3. I2 was used to evaluate heterogeneity. Results Three clinical trial studies were included with 2344 patients. In pooled ALT ‎mean difference evaluation within 24 weeks of studies, there was a significant ‎difference between subjects receiving Empagliflozin versus controls (MD=-6.6 ‎CI95%(-10.27 to -3.73; P=0.06; I2=99%). ‎ In case of AST (MD=-9.06 CI95% (-20.45 to 2.34; P=0.12; I2=98%) and Liver fat (MD=-4.46 CI95% (-10.06 to 0.77; P=0.09; I2=98%), ‎there was not any significant difference between subjects receiving Empagliflozin ‎versus controls. Conclusion While Empagliflozin seems to be effective in lowering ALT levels; further studies are needed to confirm its efficacy in lowering liver fat.

scholarly journals Non-Alcoholic Fatty Liver Disease among Type-2 Diabetes Mellitus Patients in Abha City, South Western Saudi Arabia

2018 ◽  
Vol 15 (11) ◽  
pp. 2521 ◽  
Author(s):  
Abdullah Alsabaani ◽  
Ahmed Mahfouz ◽  
Nabil Awadalla ◽  
Mustafa Musa ◽  
Suliman Al Humayed
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
Dietary Control ◽  
Alcoholic Fatty Liver ◽  
Factors Associated ◽  
Alcoholic Fatty Liver Disease

The objective of this study was to determine the prevalence and the factors associated with non-alcoholic fatty liver disease (NAFLD) among type-2 diabetes mellitus (T2DM) patients in Abha City, Southwestern Saudi Arabia. Using a cross-sectional study design, a representative sample of 245 T2DM patients were recruited from all primary healthcare centers in Abha city. A detailed medical history as well as laboratory investigations were done. NAFLD was diagnosed using abdominal ultrasound examination. The overall prevalence of NAFLD was 72.8% (95% CI: 66.6%–78.1%). In a multivariable regression analysis, the risk of NAFLD was significantly higher among overweight T2DM patients (aOR = 6.112, 95% CI: 1.529–4.432), Obese (aOR = 10.455, 95% CI: 2.645–41.326), with high ALT of more than 12 IU/L (aOR = 2.335, 95% CI: 1.096–5.062), moderate diet-compliant patients (aOR = 2.413, 95% CI: 1.003–5.805) and poor diet-compliant patients (aOR = 6.562, 95% CI: 2.056–20.967). On the other hand, high HDL (high density cholesterol) (in mg/dL) was a protective factor for NAFLD (aOR = 0.044, 95% CI: 0.005–0.365). It was concluded that NAFLD is a common association of T2DM. Increasing BMI (Body mass index), lower HDL level, and poor dietary control are significant factors associated with NAFLD among T2DM patients. Health education to improve dietary control and avoid excessive weight gain, testing for NAFLD among diabetic patients, especially those with abnormal BMI and HDL, are recommended for early detection and to ensure optimal levels of HDL.

scholarly journals Efficacy of liraglutide in treating type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease

2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Feng Tian ◽  
Zhigang Zheng ◽  
Damin Zhang ◽  
Si He ◽  
Jie Shen
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver Disease ◽  
C Reactive Protein ◽  
Alcoholic Fatty Liver ◽  
Reactive Protein ◽  
Alcoholic Fatty Liver Disease

Type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD) is difficult to treat. The present study explored the efficacy of (liraglutide) Lira in treating T2DM complicated with NAFLD. A total of 127 patients suffering from T2DM complicated with NAFLD were enrolled in the present study, and randomly assigned to a Lira group (liraglutide injection: 0.6–1.2 mg/day, 12 weeks, n=52) or a Metformin (Met) group (oral metformin: 1000–1500 mg/day, 12 weeks, n=75). During the treatment phase, the values for fasting plasma glucose (FPG), 2 h plasma glucose (2hPG), glycated hemoglobin (HbA1c), aspartate aminotransferase (AST)/alanine aminotransferase (ALT), and adiponectin (APN) decreased in both the Lira and Met groups, and the levels of Δ2hPG, ΔAST/ALT, and ΔAPN in the Lira group were significantly lower than those in the Met group. The values for total cholesterol (TC), triglycerides (TG), low-and high-density lipoproteins (LDL and HDL), ALT, AST, weight, body mass index (BMI), waist to hip ratio (WHR), and C-reactive protein were markedly increased in both groups, and levels of ΔAST, ΔALT, Δweight, ΔBMI, ΔWHR, and ΔCRP (C-reactive protein) in the Lira group were significantly higher than those in the Met group. An analysis of treatment efficacy showed that liraglutide was better than metformin in its ability to significantly decrease the ALT levels in patients with combined T2DM and NAFLD. Furthermore, liraglutide was more effective than metformin at ameliorating the severity of T2DM complicated with NAFLD, and produced its effects by alleviating liver inflammation and improving liver function.

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