Effects of liraglutide, metformin and gliclazide on body composition in patients with both type 2 diabetes and non‐alcoholic fatty liver disease: A randomized trial

Aims/Introduction To compare the effects of gliclazide, liraglutide and metformin on body composition in patients with type 2 diabetes mellitus with non‐alcoholic fatty liver disease. Materials and Methods A total of 85 patients were randomly allocated to receive gliclazide (n = 27), liraglutide (n = 29) or metformin (n = 29) monotherapy for 24 weeks. Body composition was measured using dual‐energy X‐ray absorptiometry. Results Liraglutide and metformin reduced total, trunk, limb, android and gynoid fat mass; this also led to weight reduction. However, gliclazide treatment produced no significant changes in weight or fat mass, likely because reductions in fat mass were concomitant with increases in lean tissue mass. Blood glucose concentrations and glycated hemoglobin levels improved in all treatment arms; levels of the latter were lower in patients treated with liraglutide and metformin. Serum alanine aminotransferase concentrations decreased in all treatment arms, whereas serum aspartate aminotransferase concentrations were reduced only by liraglutide and metformin. In all patients, weight loss and total, trunk, limb, and android fat mass reductions were positively correlated with decreases in serum alanine aminotransferase and aspartate aminotransferase levels, whereas reductions in waist circumference were positively correlated with lower serum alanine aminotransferase levels. Conclusions Compared with gliclazide, liraglutide and metformin monotherapies result in greater weight loss, reductions in body fat mass, and better blood glucose control among type 2 diabetes mellitus patients with non‐alcoholic fatty liver disease. Reductions in weight, fat mass and waist circumference favorably affect hepatic function. This single‐center, open‐label, prospective, randomized clinical trial examined the effect of liraglutide, metformin, and gliclazide on body composition in patients with type 2 diabetes and concomitant non‐alcoholic fatty liver disease. The results show that liraglutide and metformin are superior to gliclazide in terms of reducing body weight, body mass index, and body fat mass, and in terms of improving liver function and glycosylated hemoglobin levels. In addition, liraglutide and metformin were shown to reduce fat mass rather than lean tissue mass, which is helpful in improving the body weight and glycemic control. Weight remained stable in the gliclazide group; this resulted from identical reductions in fat mass and increases in lean tissue