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Dipeptidyl Peptidase IV Inhibitors for Nonalcoholic Fatty Liver Disease - Systematic Review and Metanalysis

[ Vol. 17 , Issue. 5 ]

Author(s):

Lucas Ribeiro dos Santos*, Marcio Luis Duarte, Maria Stella Peccin, Antônio Ricardo de Toledo Gagliardi and Tamara Melnik   Pages 9 - 20 ( 12 )

Abstract:


Introduction: Hepatic steatosis is a frequent condition that afflicts, especially, obese and insulin-resistant patients. Diagnosis is usually made through imaging tests. Despite the high prevalence and risk of complications, there is no specific treatment approved, though a vast number of medications have been tested.

Objective: This study aimed to determine the efficacy of dipeptidyl peptidase IV inhibitors (i DPP- IV) in the treatment of NAFLD.

Methods: We searched the electronic databases of the Cochrane Library, MEDLINE, EMBASE, and LILACS, as well as reference lists of the included studies and grey literature; 9 studies were selected for inclusion.

Results: 7 studies were used for metanalysis for 3 outcomes. i DPP-IV showed an ALT-reducing power of MD -10.83 (95% CI 35.23 to 13.57) at 3 months and MD -9.27 (95% CI 10.92 to -7.62) at 6 months of intervention, as well as a reduction of hepatic steatosis via MRI of SMD 0.10 (95% CI 0.31 to 0.50); the overall incidence of adverse events was very low. The studies were considered of low and very low quality by the GRADE evaluation.

Conclusion: Because of the overall poor quality of the studies and heterogeneity of the population analyzed, i DPP-IV did not show efficacy on inflammatory markers or fibrosis in patients with NAFLD.

Keywords:

Dipeptidyl-Peptidase IV inhibitors, fatty liver, steatohepatitis, type 2 diabetes mellitus, obesity, systematic review.

Affiliation:

Department of Internal Medicine, Faculty of Medical Sciences of Santos - Lusiada University, Santos/SP, Oswaldo Cruz St, 179 - Boqueirão, Santos - SP, 11015-300, Evidence based Medicine Department, Federal university of São Paulo - UNIFESP, São Paulo/SP, Pedro de Toledo St, 598 - São Paulo, SP - CEP: 4039001, Evidence based Medicine Department, Federal university of São Paulo - UNIFESP, São Paulo/SP, Pedro de Toledo St, 598 - São Paulo, SP - CEP: 4039001, Angiocorpore - Cardiovascular Institute of Santos, Santos/SP, Tocantins St, 70 - Santos, SP. CEP 11055-341, Evidence based Medicine Department, Federal university of São Paulo - UNIFESP, São Paulo/SP, Pedro de Toledo St, 598 - São Paulo, SP - CEP: 4039001



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