TO STUDY THE SAFETY AND EFFICACY OF ACARBOSE ON POCD WITH NAFLD PATIENT

Authors

  • Rohit Mittal Department of Pharmacology, IEC University, Baddi, Himachal Pradesh -174103, India. Author
  • Amarjeet Singh Department of Pharmacology, IEC University, Baddi, Himachal Pradesh -174103, India. Author
  • Shweta Bhandari Department of Endocrinology, Vincare Hospital, Bathinda, Punjab -151001, India. Author

Keywords:

NAFLD, PCOC, Fatty Liver, Ovary, Lipid

Abstract

In this study group falls age ranged between 18 – 65 years. A wide range of age groups were selected for the present study and were classified in to four categories. Overall average age in study 31.56 years. We found change in average BMI after treatment of Acarbose from 26.20 kg/m2 to 25.51 kg/m2 (Percentage change- 2.6). The level of PPBG was high at baseline, the mean PPBG was 175.17mg/dl. There was a significant reduction Of PPBG after treatment of acarbose was 110.82 was reduced by 36.73%. The mean values of LH in PCOS with NAFLD were singnificantly higher i.e., 9.24 before treatment and after 06 month treatment of acarbose the mean value were significant change i.e.,7.48. The higher level of LH in all age groups. Acarbose showed (19.88%) reduction in liver thickness in comparison to before treatment. PCOS women reflected the highest values of testosterone 4.29 in the present study at baseline and it was significantly decline after 06 month of Acarbose treatment 1.75 was reduced by 59.2%.

References

Yki-Järvinen H. Fat in the liver and insulin resistance. Ann Med. 2005;37(5):347-56. doi: 10.1080/07853890510037383. PMID: 16179270.

Hossain N, Stepanova M, Afendy A, Nader F, Younossi Y, Rafiq N, Goodman Z, Younossi ZM. Non-alcoholic steatohepatitis (NASH) in patients with polycystic ovarian syndrome (PCOC). Scand J Gastroenterol. 2011 Apr;46(4):479-84. doi: 10.3109/00365521.2010.539251. Epub 2010 Nov 30. PMID: 21114431.

Baranova A, Tran TP, Birerdinc A, Younossi ZM. Systematic review: association of polycystic ovary syndrome with metabolic syndrome and non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2011 Apr;33(7):801-14. doi: 10.1111/j.1365-2036.2011.04579.x. Epub 2011 Jan 20. PMID: 21251033.

Wu J, Yao XY, Shi RX, Liu SF, Wang XY. A potential link between polycystic ovary syndrome and non-alcoholic fatty liver disease: an update meta-analysis. Reprod Health. 2018 May 10;15(1):77. doi: 10.1186/s12978-018-0519-2. PMID: 29747678; PMCID: PMC5946415.

Rojas J, Chávez M, Olivar L, Rojas M, Morillo J, Mejías J, Calvo M, Bermúdez V. Polycystic ovary syndrome, insulin resistance, and obesity: navigating the pathophysiologic labyrinth. Int J Reprod Med. 2014; 2014:719050. doi: 10.1155/2014/719050. Epub 2014 Jan 28. PMID: 25763405; PMCID: PMC4334071.

Doycheva I, Ehrmann DA. Nonalcoholic fatty liver disease and obstructive sleep apnea in women with

polycystic ovary syndrome. Fertil Steril. 2022 May;117(5):897-911. doi:

1016/j.fertnstert.2022.03.020. PMID: 35512974.

Vassilatou E. Nonalcoholic fatty liver disease and polycystic ovary syndrome. World J Gastroenterol. 2014 Jul 14;20(26):8351-63. doi: 10.3748/wjg.v20.i26.8351. PMID: 25024594; PMCID: PMC4093689.

Zhao H, Zhang J, Cheng X, Nie X, He B. Insulin resistance in polycystic ovary syndrome across various tissues: an updated review of pathogenesis, evaluation, and treatment. J Ovarian Res. 2023 Jan 11;16(1):9. doi: 10.1186/s13048-022-01091-0. PMID: 36631836; PMCID: PMC9832677.

Vryonidou A, Papatheodorou A, Tavridou A, Terzi T, Loi V, Vatalas IA, Batakis N, Phenekos C, Dionyssiou-Asteriou A. Association of hyperandrogenemic and metabolic phenotype with carotid intima-media thickness in young women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005 May;90(5):2740-6. doi: 10.1210/jc.2004-2363. Epub 2005 Mar 1. PMID: 15741256.

Vassilatou E, Lafoyianni S, Vryonidou A, Ioannidis D, Kosma L, Katsoulis K, Papavassiliou E, Tzavara I. Increased androgen bioavailability is associated with non-alcoholic fatty liver disease in women with polycystic ovary syndrome. Hum Reprod. 2010 Jan;25(1):212-20. doi: 10.1093/humrep/dep380. Epub 2009 Nov 3. PMID: 19887498.

I S Sobczak A, A Blindauer C, J Stewart A. Changes in Plasma Free Fatty Acids Associated with Type-2 Diabetes. Nutrients. 2019 Aug 28;11(9):2022. doi: 10.3390/nu11092022. PMID: 31466350; PMCID: PMC6770316.

Henderson GC. Plasma Free Fatty Acid Concentration as a Modifiable Risk Factor for Metabolic Disease. Nutrients. 2021 Jul 28;13(8):2590. doi: 10.3390/nu13082590. PMID: 34444750; PMCID: PMC8402049.

Mittelman SD, Bergman RN. Inhibition of lipolysis causes suppression of endogenous glucose production independent of changes in insulin. Am J Physiol Endocrinol Metab. 2000 Sep;279(3):E630-7. doi: 10.1152/ajpendo.2000.279.3.E630. PMID: 10950832.

Jinjuvadia R, Antaki F, Lohia P, Liangpunsakul S. The Association Between Nonalcoholic Fatty Liver Disease and Metabolic Abnormalities in The United States Population. J Clin Gastroenterol. 2017 Feb;51(2):160-166. doi: 10.1097/MCG.0000000000000666. PMID: 27580477; PMCID: PMC5218881.

Marušić M, Paić M, Knobloch M, Liberati Pršo AM. NAFLD , Insulin Resistance, and Diabetes Mellitus Type 2. Can J Gastroenterol Hepatol. 2021 Feb 17;2021:6613827. doi: 10.1155/2021/6613827. PMID: 33681089; PMCID: PMC7904371.

Wilson PW, D'Agostino RB, Parise H, Sullivan L, Meigs JB. Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation. 2005 Nov 15;112(20):3066-72. doi: 10.1161/CIRCULATIONAHA.105.539528. Epub 2005 Nov 7. PMID: 16275870.

Dowman JK, Tomlinson JW, Newsome PN. Pathogenesis of non-alcoholic fatty liver disease. QJM. 2010 Feb;103(2):71-83. doi: 10.1093/qjmed/hcp158. Epub 2009 Nov 13. PMID: 19914930; PMCID: PMC2810391.

Godoy-Matos AF, Silva Júnior WS, Valerio CM. NAFLD as a continuum: from obesity to metabolic syndrome and diabetes. Diabetol Metab Syndr. 2020 Jul 14;12:60. doi: 10.1186/s13098-020-00570-y. PMID: 32684985; PMCID: PMC7359287.

Rosenfield RL, Ehrmann DA. The Pathogenesis of Polycystic Ovary Syndrome (PCOC): The Hypothesis of PCOC as Functional Ovarian Hyperandrogenism Revisited. Endocr Rev. 2016 Oct;37(5):467-520. doi: 10.1210/er.2015-1104. Epub 2016 Jul 26. PMID: 27459230; PMCID: PMC5045492.

Ashraf, S., Nabi, M., Rasool, S.u.A. et al. Hyperandrogenism in polycystic ovarian syndrome and role of CYP gene variants: a review. Egypt J Med Hum Genet 20, 25 (2019). https://doi.org/10.1186/s43042-019-0031-4.

Ziolkowska S, Binienda A, Jabłkowski M, Szemraj J, Czarny P. The Interplay between Insulin Resistance, Inflammation, Oxidative Stress, Base Excision Repair and Metabolic Syndrome in Nonalcoholic Fatty Liver Disease. Int J Mol Sci. 2021 Oct 15;22(20):11128. doi: 10.3390/ijms222011128. PMID: 34681787; PMCID: PMC8537238.

Shao M, Ye Z, Qin Y, Wu T. Abnormal metabolic processes involved in the pathogenesis of non-alcoholic fatty liver disease (Review). Exp Ther Med. 2020 Nov;20(5):26. doi: 10.3892/etm.2020.9154. Epub 2020 Aug 28. PMID: 32934691; PMCID: PMC7471863.

Vesković M, Šutulović N, Hrnčić D, Stanojlović O, Macut D, Mladenović D. The Interconnection between Hepatic Insulin Resistance and Metabolic Dysfunction-Associated Steatotic Liver Disease-The Transition from an Adipocentric to Liver-Centric Approach. Curr Issues Mol Biol. 2023 Nov 14;45(11):9084-9102. doi: 10.3390/cimb45110570. PMID: 37998747; PMCID: PMC10670061.

Legro RS, Arslanian SA, Ehrmann DA, Hoeger KM, Murad MH, Pasquali R, Welt CK; Endocrine Society. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013 Dec;98(12):4565-92. doi: 10.1210/jc.2013-2350.

Huddleston HG, Dokras A. Diagnosis and Treatment of Polycystic Ovary Syndrome. JAMA. 2022 Jan 18;327(3):274-275. doi: 10.1001/jama.2021.23769. PMID: 35040896.

Loomba R, Friedman SL, Shulman GI. Mechanisms and disease consequences of nonalcoholic fatty liver disease. Cell. 2021 May 13;184(10):2537-2564. doi: 10.1016/j.cell.2021.04.015. PMID: 33989548.

Gariani K, Jornayvaz FR. Pathophysiology of NASH in endocrine diseases. Endocr Connect. 2021 Feb;10(2):R52-R65. doi: 10.1530/EC-20-0490. PMID: 33449917; PMCID: PMC7983516.

Dharmalingam M, Yamasandhi PG. Nonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus. Indian J Endocrinol Metab. 2018 May-Jun;22(3):421-428. doi: 10.4103/ijem.IJEM_585_17. PMID: 30090738; PMCID: PMC6063173.

Lee CH, Lui DT, Lam KS. Non-alcoholic fatty liver disease and type 2 diabetes: An update. J Diabetes Investig. 2022 Jun;13(6):930-940. doi: 10.1111/jdi.13756. Epub 2022 Feb 14. PMID: 35080136; PMCID: PMC9153839.

Jornayvaz FR, Shulman GI. Diacylglycerol activation of protein kinase Cε and hepatic insulin resistance. Cell Metab. 2012 May 2;15(5):574-84. doi: 10.1016/j.cmet.2012.03.005. PMID: 22560210; PMCID: PMC3353749.

Samuel VT, Liu ZX, Wang A, Beddow SA, Geisler JG, Kahn M, Zhang XM, Monia BP, Bhanot S, Shulman GI. Inhibition of protein kinase Cepsilon prevents hepatic insulin resistance in nonalcoholic fatty liver disease. J Clin Invest. 2007 Mar;117(3):739-45. doi: 10.1172/JCI30400. Epub 2007 Feb 22. PMID: 17318260; PMCID: PMC1797607.

Kolczynska K, Loza-Valdes A, Hawro I, Sumara G. Diacylglycerol-evoked activation of PKC and PKD isoforms in regulation of glucose and lipid metabolism: a review. Lipids Health Dis. 2020 May 28;19(1):113. doi: 10.1186/s12944-020-01286-8. PMID: 32466765; PMCID: PMC7257441.

Birkenfeld AL, Shulman GI. Nonalcoholic fatty liver disease, hepatic insulin resistance, and type 2 diabetes. Hepatology. 2014 Feb;59(2):713-23. doi: 10.1002/hep.26672. PMID: 23929732; PMCID: PMC3946772.

Petta S, Gastaldelli A, Rebelos E, Bugianesi E, Messa P, Miele L, Svegliati-Baroni G, Valenti L, Bonino F. Pathophysiology of Non Alcoholic Fatty Liver Disease. Int J Mol Sci. 2016 Dec 11;17(12):2082. doi: 10.3390/ijms17122082. PMID: 27973438; PMCID: PMC5187882.

Bechmann LP, Hannivoort RA, Gerken G, Hotamisligil GS, Trauner M, Canbay A. The interaction of hepatic lipid and glucose metabolism in liver diseases. J Hepatol. 2012 Apr;56(4):952-64. doi: 10.1016/j.jhep.2011.08.025. Epub 2011 Dec 13. PMID: 22173168.

Bansal S, Vachher M, Arora T, Kumar B, Burman A. Visceral fat: A key mediator of NAFLD development and progression. Human Nutrition & Metabolism. 2023 Jul 27:200210. doi: 10.1016/j.hnm.2023.200210

Wilcox G. Insulin and insulin resistance. Clin Biochem Rev. 2005 May;26(2):19-39. PMID: 16278749;

PMCID: PMC1204764.

Rorsman P, Ashcroft FM. Pancreatic β-Cell Electrical Activity and Insulin Secretion: Of Mice and Men. Physiol Rev. 2018 Jan 1;98(1):117-214. doi: 10.1152/physrev.00008.2017. PMID: 29212789; PMCID: PMC5866358.

Heeren J, Scheja L. Metabolic-associated fatty liver disease and lipoprotein metabolism. Mol Metab. 2021 Aug;50:101238. doi: 10.1016/j.molmet.2021.101238. Epub 2021 Apr 20. PMID: 33892169; PMCID: PMC8324684.

Wasilewska N, Lebensztejn DM. Non-alcoholic fatty liver disease and lipotoxicity. Clin Exp Hepatol. 2021 Mar;7(1):1-6. doi: 10.5114/ceh.2021.104441. Epub 2021 Mar 25. PMID: 34027109; PMCID: PMC8122097.

Janssen JAMJL. Hyperinsulinemia and Its Pivotal Role in Aging, Obesity, Type 2 Diabetes, Cardiovascular Disease and Cancer. Int J Mol Sci. 2021 Jul 21;22(15):7797. doi: 10.3390/ijms22157797. PMID: 34360563; PMCID: PMC8345990.

Chen Z, Yu R, Xiong Y, Du F, Zhu S. A vicious circle between insulin resistance and inflammation in nonalcoholic fatty liver disease. Lipids Health Dis. 2017 Oct 16;16(1):203. doi: 10.1186/s12944-017-0572-9. Erratum in: Lipids Health Dis. 2018 Feb 23;17 (1):33. PMID: 29037210; PMCID: PMC5644081.

Leclercq IA, Da Silva Morais A, Schroyen B, Van Hul N, Geerts A. Insulin resistance in hepatocytes and sinusoidal liver cells: mechanisms and consequences. J Hepatol. 2007 Jul;47(1):142-56. doi: 10.1016/j.jhep.2007.04.002. Epub 2007 Apr 16. PMID: 17512085.

Gastaldelli A. Measuring and estimating insulin resistance in clinical and research settings. Obesity (Silver Spring). 2022 Aug;30(8):1549-1563. doi: 10.1002/oby.23503. PMID: 35894085; PMCID: PMC9542105.

Armandi A, Rosso C, Caviglia GP, Bugianesi E. Insulin Resistance across the Spectrum of Nonalcoholic Fatty Liver Disease. Metabolites. 2021 Mar 8;11(3):155. doi: 10.3390/metabo11030155. PMID: 33800465; PMCID: PMC8000048.

Fujii H, Kawada N, Japan Study Group Of NAFLD Jsg-NAFLD . The Role of Insulin Resistance and Diabetes in Nonalcoholic Fatty Liver Disease. Int J Mol Sci. 2020 May 29;21(11):3863. doi: 10.3390/ijms21113863. PMID: 32485838; PMCID: PMC7312931.

Jelenik T, Kaul K, Séquaris G, Flögel U, Phielix E, Kotzka J, Knebel B, Fahlbusch P, Hörbelt T, Lehr S, Reinbeck AL, Müller-Wieland D, Esposito I, Shulman GI, Szendroedi J, Roden M. Mechanisms of Insulin Resistance in Primary and Secondary Nonalcoholic Fatty Liver. Diabetes. 2017 Aug;66(8):2241-2253. doi: 10.2337/db16-1147. Epub 2017 May 10. PMID: 28490610; PMCID: PMC5521856.

DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary

syndrome using the homeostasis model assessment. Fertil Steril. 2005 May;83(5):1454-60. doi: 10.1016/j.fertnstert.2004.11.070. PMID: 15866584.

Marshall JC, Dunaif A. Should all women with PCOC be treated for insulin resistance? Fertil Steril. 2012 Jan;97(1):18-22. doi: 10.1016/j.fertnstert.2011.11.036. PMID: 22192137; PMCID: PMC3277302.

Barber TM, Dimitriadis GK, Andreou A, Franks S. Polycystic ovary syndrome: insight into pathogenesis and a common association with insulin resistance. Clin Med (Lond). 2016 Jun;16(3):262-6. doi: 10.7861/clinmedicine.16-3-262. PMID: 27251917; PMCID: PMC5922706.

Barber TM, Dimitriadis GK, Andreou A, Franks S. Polycystic ovary syndrome: insight into pathogenesis and a common association with insulin resistance. Clin Med (Lond). 2015 Dec;15 Suppl 6:s72-6. doi: 10.7861/clinmedicine.15-6-s72. PMID: 26634686.

Downloads

Published

2024-04-05

How to Cite

Rohit Mittal, Amarjeet Singh, & Shweta Bhandari. (2024). TO STUDY THE SAFETY AND EFFICACY OF ACARBOSE ON POCD WITH NAFLD PATIENT. INTERNATIONAL JOURNAL OF ADVANCED RESEARCH IN ENGINEERING AND TECHNOLOGY (IJARET), 15(2), 12-30. https://lib-index.com/index.php/IJARET/article/view/IJARET_15_02_002