Effect of sitagliptin on intrahepatic lipid content and body fat in patients with type 2 diabetes

•The subjects were Japanese patients with T2DM with a BMI ≥ 25 kg/m2 or fatty liver.•A prospective, 24-week, single-center, open-label comparative study enrolled.•Treatment with sitagliptin or glimepiride reduced HbA1c and GA similarly.•After 24 weeks, only sitagliptin decreased IHL and total body fat mass.

AimsTo evaluate the effect of the DPP-4 inhibitor sitagliptin on intrahepatic lipid (IHL) content and body fat in overweight Japanese patients with type 2 diabetes.MethodsA prospective, 24-week, single-center, open-label comparative study enrolled 20 Japanese patients with type 2 diabetes (male: 11, female: 9) with a BMI ≥ 25 kg/m2 or fatty liver. Subjects were randomly assigned to receive treatment with sitagliptin (25 mg titrated up to 50 mg: S) or glimepiride (0.5 mg titrated up to 1 mg: G). After starting each treatment, IHL and total fat mass were evaluated by 1H-magnetic resonance spectroscopy (1H-MRS) and dual energy X-ray absorptiometry (DEXA), respectively at baseline and at 12 weeks and 24 weeks.ResultsAfter 24 weeks, HbA1c levels showed a similar significant decrease in both groups from 7.2 (7.0, 7.5) to 6.6 (6.4, 6.8)%, (54 (53, 56) to 48(47, 49) mmol/mol) with S and 7.3(6.8, 7.4) to 6.6 (6.3, 6.7)%, (55 (51, 56) to 48 (46, 49) mmol/mol) with G, median (interquartile range), p < 0.05 vs. baseline, with no significant differences between the two groups. The IHL and total body fat mass were decreased in S group from 24.5(18.9, 36.6) to 20.5 (14.6, 28.5)% (p = 0.009) and 22.5 (20.6, 33.7) to 21.6 (19.7, 32.4)kg (p = 0.028), respectively, but not in G group.ConclusionsOur findings indicate that sitagliptin and glimepiride achieved similar glycemic control, but only sitagliptin reduced IHL and total body fat (UMIN: 000013356).