Division of Hepatology, Saga Medical School, Saga, Japan.
Hepatol Res. 2015 Mar;45(3):269-78. doi: 10.1111/hepr.12351. Epub 2014 May 28.
Non-alcoholic fatty liver disease (NAFLD), a hepatic manifestation of metabolic syndrome, is associated with an increased risk of developing lifestyle-related diseases including type 2 diabetes, cardiovascular disease and cerebral vessel disease. No current drug therapy provides the ideal effects of decreasing hepatic inflammation while simultaneously improving liver fibrosis. Liraglutide is a glucagon-like peptide-1 receptor agonist that affects the histological findings in patients with non-alcoholic steatohepatitis (NASH). This study was conducted to evaluate the effect and action of liraglutide for biopsy-proven NASH.
After lifestyle modification intervention for 24 weeks, subjects whose hemoglobin A1c levels failed to improve to less than 6.0% and/or whose alanine aminotransferase levels were not lower than baseline, received liraglutide at 0.9 mg/body per day for 24 weeks.
Of 27 subjects, 26 completed the lifestyle modification intervention. Nineteen subjects received liraglutide therapy for 24 weeks. Body mass index, visceral fat accumulation, aminotransferases and glucose abnormalities improved significantly. Repeated liver biopsy was performed in 10 subjects who continued liraglutide therapy for 96 weeks. Six subjects showed decreased histological inflammation as determined by NASH activity score and stage determined by Brunt classification. We saw no significant adverse events during therapy with liraglutide.
Our pilot study demonstrated that treatment with liraglutide had a good safety profile and significantly improved liver function and histological features in NASH patients with glucose intolerance.
非酒精性脂肪性肝病(NAFLD)是代谢综合征的肝脏表现,与包括 2 型糖尿病、心血管疾病和脑血管疾病在内的生活方式相关疾病的发病风险增加有关。目前尚无药物治疗能同时降低肝脏炎症和改善肝纤维化,提供理想的效果。利拉鲁肽是一种胰高血糖素样肽-1 受体激动剂,可影响非酒精性脂肪性肝炎(NASH)患者的组织学发现。本研究旨在评估利拉鲁肽对活检证实的 NASH 的疗效和作用。
在生活方式改变干预 24 周后,糖化血红蛋白(HbA1c)水平未降至<6.0%且/或丙氨酸氨基转移酶(ALT)水平未低于基线的患者接受利拉鲁肽治疗,剂量为 0.9mg/天,疗程 24 周。
27 例患者中,26 例完成了生活方式改变干预。19 例患者接受利拉鲁肽治疗 24 周。体重指数、内脏脂肪堆积、转氨酶和葡萄糖异常均显著改善。10 例继续接受利拉鲁肽治疗 96 周的患者重复进行了肝活检。6 例患者的 NASH 活动评分和 Brunt 分级确定的分期的组织学炎症均有下降。在利拉鲁肽治疗期间未观察到明显的不良事件。
本研究初步证实,利拉鲁肽治疗具有良好的安全性,可显著改善葡萄糖耐量异常的 NASH 患者的肝功能和组织学特征。