Effect of Liraglutide, Metformin, and Gliclazide on Body Composition in Type 2 Diabetic Patients with Nonalcoholic Fatty Liver Disease—A Randomised Trial

Objective: To compare the effects of gliclazide, liraglutide, and metformin on body composition in type 2 diabetes mellitus (T2DM) patients with nonalcoholic fatty liver disease (NAFLD). Methods: Eighty-five subjects were randomly allocated and received 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 weight and total, trunk, limb, android, and gynoid fat mass. However, no significant changes in weight or fat mass occurred with gliclazide. In the liraglutide and metformin arms, weight loss was mainly due to reductions in total, trunk, limb, android, and gynoid fat mass. The stable weight obtained with gliclazide resulted from identical reductions in fat mass and increases in lean tissue mass. Blood glucose concentrations and glycated haemoglobin A1c (HbA1c) levels improved in all treatment arms, but lower HbA1c levels were found with liraglutide and metformin. Serum alanine aminotransferase (ALT) concentrations decreased in all treatment arms, whereas serum aspartate aminotransferase (AST) concentrations reduced with liraglutide and metformin only. For all subjects, weight loss and total, trunk, limb, and android fat mass reductions were positively correlated with reductions in serum ALT and AST concentrations, and reductions in waist circumference were positively correlated with reductions in serum ALT concentrations. Conclusions: As compared with gliclazide monotherapy, liraglutide and metformin monotherapies resulted in greater weight loss, reductions in body fat mass, and improvements in liver function and blood glucose control among patients with T2DM and NAFLD. Disclosure W. Feng: None. Y. Bi: None. P. Li: None. T. Yin: None. C. Gao: None. S. Shen: None. L. Gao: None. C. Jiang: None. D. Zhu: None.