Roy Sayak
Dept. of Internal Medicine, Medica Superspeciality Hospital, Kolkata, India.
Case Rep Med. 2020 Mar 27;2020:4287075. doi: 10.1155/2020/4287075. eCollection 2020.
Diabetes and other metabolic abnormalities including high triglycerides (TGs) are commonly seen comorbid conditions in patients having nonalcoholic fatty liver disease (NAFLD). There is no approved pharmacotherapy for NAFLD, and life-style therapy plays a major role. Saroglitazar, the world's first approved dual PPAR / agonist, is approved in India for the treatment of diabetic dyslipidemia. The objective of this case series analysis was to evaluate the safety and effectiveness of saroglitazar 4 mg once daily in reducing liver stiffness in patients having diabetic dyslipidemia associated NAFLD.
In this retrospective case series analysis, we identified 10 patients with diabetic dyslipidemia (type 2 diabetes and triglycerides >200 mg/dL at baseline) and NAFLD who were treated with saroglitazar 4 mg once daily and the follow-up data were available for 9 months after saroglitazar treatment. At baseline, all patients were on stable antidiabetic and statin therapy. Liver stiffness was measured by using 2D shear wave elastography at baseline and at 9-month follow-up.
At 9-month follow-up after saroglitazar treatment, significant improvement was observed in shear wave velocity (SWV) and serum transaminases levels. Serum TG level was significantly reduced after 9-month treatment with saroglitazar. No major adverse event was reported.
In this case series of 10 patients with diabetic dyslipidemia and NAFLD, saroglitazar improved liver stiffness along with reduction observed in liver enzymes and TG values. Long-term randomized controlled clinical trial is required to further establish the safety and efficacy of saroglitazar in treatment of NAFLD.
糖尿病及其他代谢异常(包括高甘油三酯血症)在非酒精性脂肪性肝病(NAFLD)患者中是常见的合并症。目前尚无获批用于NAFLD的药物治疗方法,生活方式治疗起主要作用。世界首个获批的双靶点过氧化物酶体增殖物激活受体(PPAR)激动剂西格列他扎在印度获批用于治疗糖尿病血脂异常。本病例系列分析的目的是评估每日一次服用4毫克西格列他扎对降低合并糖尿病血脂异常的NAFLD患者肝脏硬度的安全性和有效性。
在这项回顾性病例系列分析中,我们纳入了10例合并糖尿病血脂异常(2型糖尿病且基线甘油三酯>200毫克/分升)和NAFLD的患者,他们接受每日一次4毫克西格列他扎治疗,且在西格列他扎治疗后有9个月的随访数据。基线时,所有患者均接受稳定的抗糖尿病和他汀类药物治疗。在基线和9个月随访时使用二维剪切波弹性成像测量肝脏硬度。
西格列他扎治疗9个月随访时,观察到剪切波速度(SWV)和血清转氨酶水平有显著改善。西格列他扎治疗9个月后血清甘油三酯水平显著降低。未报告重大不良事件。
在这个包含10例合并糖尿病血脂异常和NAFLD患者的病例系列中,西格列他扎改善了肝脏硬度,同时观察到肝酶和甘油三酯值降低。需要进行长期随机对照临床试验以进一步确定西格列他扎治疗NAFLD的安全性和有效性。