Efficacy of sitagliptin combined with metformin in the initial treatment of type 2 diabetes with non-alcoholic fatty liver

Objective:To observe the clinical efficacy of sitagliptin combined with metformin in the treatment of newly diagnosed patients with type 2 diabetes mellitus and non-alcoholic fatty liver disease(NAFLD).Methods:Totally 67 patients with type 2 diabetes mellitus complicated with NAFLD were randomly assigned to two groups.Patients received the diet therapy,and oral hypoglycemic agents that were either metformin(500 mg,tid) + sitagliptin(100 mg,qd) or metformin + glipizide(2.5 ~ 5 mg tid,control).The changes in following variables were recorded and compared.The variables were body weight,BMI,liver function(AST,ALT and GGT),OGTT(synchronization tests of fasting and 2 h after breakfast blood for glucose and insulin),blood lipids(TC and TG),glycosylated hemoglobin(HbA1C),liver ultrasound,and calculating insulin resistance index(HOMA-IR).Results:After treatment for 16 weeks,AST,ALT,GGT and HOMA-IR of patients in two groups were significantly improved compared with pre-treatment(P 0.05),and sitagliptin + metformin was significantly more effective thanglipizide + metformin(P 0.01).After treatment,blood glucose,TC and TG levels were significantly reduced,and the difference between groups was not statistically significant.As to the fatty liver,the effective rate(91%) in sitagliptin + metformin group was significantly higher than that(52%) in glipizide + metformin group(P 0.01).Conclusion:Sitagliptin combined with metformin is effective in the treatment of type 2 diabetes patients complicated with NAFLD,which is superior to metformin combined with sulfonylureas.