الفهرس 
Literature reviewOnly 14 pages are availabe for public view
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Abstract
Nonalcoholic fatty liver disease (NAFLD) is emerging as an important public health problem across the globe and associated with high risk for cardiovascular disease (CVD) for adult and children. NAFLD refers to a wide spectrum of liver damage, ranging from simple steatosis to steatohepatitis, advanced fibrosis, and cirrhosis.
NAFLD is closely linked to insulin resistance and other metabolic risk factors such as diabetes mellitus, central abdominal obesity and dyslipidemia. It is an independent risk factor for cardiovascular disease (CVD) and predicts future events regardless of other risk factors such as age, gender, low density lipoprotein (LDL) cholesterol, smoking and other metabolic risk factors characteristics
Despite a growing knowledge of NAFLD pathogenesis mechanisms, few efficient therapies are accessible. Current treatments focus mainly on enhancing metabolic parameters that contribute to pathogenesis of disease, such as weight loss and exercise, reduction of IR, and improvement of diabetic control.
High fat diet (HFD) in control group showed bad histopathological changes in the liver, increase in liver enzymes, hepatic malondialdehyde, inflammatory cytokines, cholesterol, triglyceride and hyperinsulinemia.
Metformin as insulin sensitizer in a daily dose of 60 mg/kg orally , improved the pathological abnormalities seen in NAFLD. It attenuated liver enzymes, lipid profile and insulin resistance. It decreased inflammation and oxidative stress markers.
Exenatide is a synthetic GLP-1 receptor agonist form of exendin-4, a peptide secreted in the Gila monster saliva ; it shares 53% homology with the human GLP-1 amino acid sequence and cannot readily be degraded by the DPP-IV enzyme. It decreased the body weight, improved lipid profile and liver enzymes, lessened the elevated insulin resistance induced by high fat diet.It was superior to metformin in decreasing body weight and enhancing hepatic enzymes and liver steatosis. Treatment with exenatide reversed the impact of HFD on the inflammatory and oxidative stress markers.
Conclusion: many of abnormalities caused by HFD-induced NAFLD could be attenuated by exenatide and metformin and the protective effect achieved by exenatide was greater than that achieved by metformin. Further clinical investigations should be done to assure the hepatoprotective effects of these drugs in experimental animals and in managing patients with NAFLD.NAFLD group showed hepatic steatosis, increase in blood glucose, insulin, liver enzymes levels, hepatic malondialdehyde inflammatory mediators. Exenatide in different doses and metformin showed significant improvement in most evaluated markers. Results obtained by exenatide in a dose dependent manner were better than that of metformin treated group. The study suggested the role of exenatide in treatment of NAFLD.