Scientists have uncovered a way to improve liver metabolism for those with non-alcoholic fatty liver disease by using an acute dose of an existing diabetes treatment
April 15, 2016, Barcelona, Spain: A type 2 diabetes treatment has been found to also have ‘off-label’ benefits for glucose control in the liver and in fatty cells known as adipose.1 Presented at The International Liver CongressTM 2016 in Barcelona, Spain, today, the study shows that exenatide, a treatment that targets the pancreas to improve glucose absorption, enhances glucose uptake and reduces insulin resistance in the liver and in adipose tissue.
Non-alcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in the liver. In some cases this accumulation of fat can cause inflammation of the liver and eventually lead to permanent scarring (cirrhosis), which can seriously impair the liver’s ability to function. NAFLD is closely associated with obesity and diabetes and the consequences of the condition can be grave, representing a major global public health problem.2 Two large European studies reported NAFLD prevalence rates of between approximately 43% and 70% in adults with type 2 diabetes.3
“There has been much discussion around the benefit of using injectable diabetes treatments, such as exenatide, on other tissues than the pancreas to improve glucose control,” said Dr Amailia Gastaldelli, Institute of Clinical Physiology, CNR, Pisa, Italy, University of Texas Health Science Center, San Antonio, USA, and lead author of the study. “This is why we set out to evaluate the effects of exenatide on the liver and adipose tissue; to better understand the benefits this treatment could offer to a wider group of patients.”
Male participants (n=15) with a fatty liver index score of >30 (a classification system that ranges from 0 to 100)4 were tested on two occasions. Those with a score <30 are deemed to have a negative likelihood of having fatty liver. Exenatide or placebo was injected 30 minutes before an oral glucose test in the double blinded study. The test measured glucose uptake in liver tissue and abdominal adipose tissue glucose uptake.
The results showed that acute exenatide administration (5mcg) decreased glucose production and insulin resistance (p=0.02) in the liver tissue when blood sugars were low. The treatment also improved liver tissue uptake of glucose when it is eaten (p=0.039). Furthermore, exenatide decreased insulin resistance in fatty adipose tissue (p=0.009).
“This interesting study shows promising findings for the many people around the world who suffer from non-alcoholic fatty liver disease,” says Professor Tom Hemming Karlsen, EASL Vice-Secretary. “The authors have succeeded in identifying an existing treatment that can improve liver metabolism, which is an important step forward for the hepatology community.”
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About The International Liver Congress™
This annual congress is the biggest event in the EASL calendar, attracting scientific and medical experts from around the world to learn about the latest in liver research. Attending specialists present, share, debate and conclude on the latest science and research in hepatology, working to enhance the treatment and management of liver disease in clinical practice. This year, the congress is expected to attract approximately 10,000 delegates from all corners of the globe. The International Liver Congress™ takes place from April 13 – 17, 2016, at the Fira Barcelona Gran Via, Barcelona, Spain.
About EASL (www.easl.eu)
Since EASL’s foundation in 1966, this not-for-profit organisation has grown to over 4,000 members from all over the world, including many of the leading hepatologists in Europe and beyond. EASL is the leading liver association in Europe, having evolved into a major European Association with international influence, with an impressive track record in promoting research in liver disease, supporting wider education and promoting changes in European liver policy.
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Onsite location reference
Fatty liver disease, Hall 8.0
Friday 15 April, 16:00 – 18:00
Presenter: Amailia Gastaldelli, Italy
Abstract: PS072, Exenatide Exerts its Positive Effects on Liver by Reducing Both Hepatic and Adipose Tissue Insulin Resistance
Author disclosures of interest
Research related to this abstract was funded by Amylin, Astra Zeneca and BMS. Consultant for Eli Lilly, Sanofi Aventis, and Roche.
1 Science Daily. Reference terms. Adipose Tissue. Available from: http://www.sciencedaily.com/terms/adipose_tissue.htm. Last accessed: March 2016.
2 World Gastroenterology Organisation Global Guidelines. Non-alcoholic Fatty Liver Disease and Non-alcoholic Steatohepatitis. Available from: http://www.worldgastroenterology.org/assets/export/userfiles/2012_NASH%20and%20NAFLD_Final_long.pdf. Last accessed: March 2016.
3 European Association for the Study of the Liver. The Burden of Liver Disease in Europe. Available from: http://www.easl.eu/medias/EASLimg/Discover/EU/54ae845caec619f_file.pdf. Last accessed: March 2016.
4 Bio Med Central. The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population. Available from: http://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-6-33. Last accessed March 2016.