Progress of antidiabetic drugs in non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is a multi-system metabolic disorder and is closely associated with insulin resistance and type 2 diabetes. It has become a common and frequently occurring disease that seriously affects health. Drugs have not been approved for the treatment of NAFLD. Antidiabetic drugs are one of the most promising drugs, including thiazolidinediones(TDZs), peroxisome proliferators-activated receptor(PPAR) agonists α/γ and α/δ, biguanides (metformin), human glucagon-like peptide-1 (GLP-1) analogues, and sodium glucoseco-transporter 2 (SGLT2) inhibitors, etc. These drugs have certain positive roles in controlling body weight, reducing liver fat content, improving hepatic steatosis and balloon degeneration, improving non alcoholic steatohepatitis (NASH), reducing inflammation, lowering blood sugar, lowering blood lipids, improving liver function, and improving antioxidant capacity. TDZs (pioglitazone) have the most adequate clinical evidences and the most clear treatment mechanisms, but are limited by their safety and tolerability. Metformin is a safe drug, but the role of NAFLD is controversial. New drugs such as PPAR-α/γ and α/δ double agonists (saroglitazar and GFT505), liraglutide (GLP-1 analogue) are in clinical trials. The data show that they have good effects on NAFD and NASH, and the securities are good. NAFLD and NASH have favorable improvement, and good safety. It should be emphasized that measures such as changing unhealthy lifestyles and weight control are still the basic treatment measures for NAFLD.