AbstractNon-alcoholic fatty liver disease (NAFLD) is currently the most common cause of
chronic liver disease. However, the treatment is limited. The aim of this
meta-analysis was to evaluate the effects and safety of sitagliptin, a selective
inhibitor of dipeptidyl peptidase-4 (DPP-4I), in treating NAFLD. Studies were
sourced from electronic databases including PubMed, CENTRAL (Cochrane Controlled
Trials Register), Embase, Medline, Web of Science, Clinical Trials, and CNKI to
identify all randomized controlled clinical trials (RCTs) and non-RCTs in adult
patients with NAFLD. Key outcomes were changes in serum levels of liver enzymes
and improvement in hepatic histology and fat content measured by imaging or
liver biopsy. Stata14.0 and RevMan5.3 were used for the meta-analysis. Seven
studies with 269 NAFLD patients were included. Compared to the control group,
sitagliptin treatment improved serum gamma-glutamyl transpeptidase (GGT) levels
in the RCT subgroup (SMD = 0.79, 95% CI: 0.01–1.58).
However, there was no significant improvement in serum alanine aminotransferase
(ALT) or aspartate aminotransferase (AST) levels following sitagliptin
treatment. Four of the included studies performed liver imaging, but sitagliptin
treatment did not result in a significant reduction in liver fat content. Only
five participants developed sitagliptin-related gastrointestinal discomfort. Our
study suggests that sitagliptin effects individuals with NAFLD by improving
serum GGT. Although sitagliptin is safe and well tolerated in NAFLD patients, it
exerts no beneficial effects on liver transaminase and liver fat content in
these patients.
Regulation of Cytochrome P450 3A4 in Non‐Alcoholic Fatty Liver Disease by Fibroblast Growth Factor 21