Effects Of DPP-4 Inhibitor In Patients With Type 2 Diabetes And Non-alcoholic Fatty Liver Disease:a Meta-analysis

Objective:To evaluate the effects of dipeptidyl peptidase 4(DPP-4)inhibitor in Type 2diabetes(T2DM)and Nonalcoholic fatty liver disease(NAFLD).Methods:We searched for Randomized controlled trials(RCT)in Pubmed,EMBASE,Cochrane Library,Web of Science,WanFang Data,CINK and VIP from inception to April 1,2020 and collect clinical controlled trials according to selection crite.Quality assessment used the Cochrane Collaboration’s tool for assessing risk of bias.Statistical analysis was conducted by the RevMan 5.2 software of Cocharane Collaboration.We will compare outcome measures for Mean difference(MD)and Risk Ratio(RR)with 95%confidence intervals(CI)and P value.Data without heterogeneity(P≥0.1,I~2≤50%)could be pooled using fixed effect model,and those with heterogeneity(P<0.1,I~2>50%)could be solved by sesitivity analysis as well as randomized effect modle.Statistical significance was assumed at the P<0.05 level.Results:A total of 8 randomized controlled trials(2 three-arm studies,4 sitagliptin,3saxagliptin,1 vildagliptin)involving 831 patients with T2DM and NAFLD were included in the analysis.The published language of included trials was English or Chinese and follow-ups ranging from 12 weeks to 6 months.The results of systematic review showed that the experimental group was reducing alanine aminotransferase(ALT),aspartate aminotransferase(AST),fasting blood glucose(FPG),glycated hemoglobin(HbA1c),triglyceride(TG),total cholesterol(TC),body mass index(BMI),insulin resistance index(HOMA-IR)compared with the control group,and the difference was statistically significant(P value<0.05).In terms of reducing the incidence of adverse reactions,the difference was not statistically significant(P value>0.05).In terms of liver fat improvement,three studies used color Doppler ultrasound to indicate that the test group was compared with the control group.The difference was statistically significant.One study used CT detection and one used liver fat degeneration quantitative test to obtain the same results.The other three An MRI study showed that the difference between the experimental group and the control group was not statistically significant.Conclusions:1.DPP-4 inhibitors can reduce BMI,HOMA-IR,blood sugar,triglycerides,and total cholesterol levels in patients with type 2 diabetes and non-alcoholic fatty liver disease.2.DPP-4 inhibitor can slightly reduce the level of transaminase in patients with type 2 diabetes and non-alcoholic fatty liver disease.