Dynamic Change of Focal Fatty Sparing in Non-Alcoholic Fatty Liver Disease after Treatment with Sitagliptin

Introduction

Non-alcoholic fatty liver disease (NAFLD) is considered to be a hepatic manifestation of metabolic syndrome and is associated with insulin resistance, type 2 diabetes mellitus, obesity, hypertension, and dyslipidemia (T. Fukuhara et al. Hepatogastroenterology 2014; 61: 323–328).

The current gold standard for the diagnosis of hepatic steatosis is a liver biopsy with a histopathological evaluation. However, less invasive and highly accurate diagnostic methods for the detection of fatty liver are currently being advocated, including abdominal ultrasound, CT, and MRI. Abdominal ultrasound may be the best and most available diagnostic modality for an initial fatty liver diagnosis (O.W. Hamer et al. Radiographics 2006; 26: 1637–1653).

Based on diagnostic images, there are 3 established fatty liver patterns (O.W. Hamer et al. Radiographics 2006; 26: 1637–1653): i/ diffuse homogeneous fatty liver, ii/ diffuse fatty liver with focal fatty sparing (i. e., with areas without steatosis), and iii/ focal fatty lesions in an otherwise normal liver.

The dipeptidyl peptidase-4 (DPP-4) inhibitor, sitagliptin, has been reported to improve or even reverse hepatic steatosis in patients with type 2 diabetes mellitus (T. Fukuhara et al. Hepatogastroenterology 2014; 61: 323–328).