Nowadays we notice the increase of cases that combine type two diabetes mellitus, and nonalcoholic fatty liver disease. As a result, the course of disease aggravates. The pathogenesis, diagnoses and treatment of NAFLD remain unclear.
The objective: of our study is to determine the clinical efficacy of an improved therapeutic measures set in patients with type 2 diabetes and NAFLD.
Materials and methods. We’ve examined 132 patients with type 2 diabetes mellitus and NAFLD. All patients gave their consent to participate in the study. They also received all necessary nutrition and workout recommendations. We split the patients into two groups. First group patients (n=37) received antihyperglycemic drugs (metformin, gliclazide or glimepiride). Patients of the second group (n=95) additionally received DPP-4 inhibitors (saxagliptin or sitagliptin), atorvastatin, and the multiprobiotic. Patients of the second group were divided into 2 subgroups: 2A group with standard level of transaminases, and 2B group with an increased level of transaminases accordingly.
Results. Improved set of therapeutic measures revealed distinctively positive effect on the dynamics of clinical manifestation of lesions of the hepatobiliary system in patients with diabetes. There were no such changes in another group. Under the influence of complex treatment in the second group of patients, the functional state of liver improved due to a significant decrease of ALT, AST, TG and VLDL levels in the blood serum. Size of the liver decreased, liver stiffness indicators improved according to shear wave elastography data.
Conclusions. Combined therapy, which includes DPP-4 inhibitors, statins and multiperiodic is effective in the treatment of patients with type two diabetes and nonalcoholic fatty liver disease.
Histopathological differences utilizing the nonalcoholic fatty liver disease activity score criteria in diabetic (type 2 diabetes mellitus) and non-diabetic patients with nonalcoholic fatty liver disease
