Introduction:
Nonalcoholic fatty liver disease (NAFLD) with type 2 diabetes mellitus (T2DM) is associated with severe clinical outcomes. MicroRNA (miR)-210 has been reported to be related to T2DM and lipid metabolism. This study aimed to determine whether miR-210 can predict the effects of glimepiride and linagliptin on NAFLD with T2DM.

Material and methods:
A total of 86 patients with NAFLD with T2DM were randomly categorized into two groups and treated with either linagliptin (5 mg/daily) or glimepiride (2 mg/daily) for 6 months. Furthermore, real-time quantitative polymerase chain reaction was used to evaluate the expression level of miR-210 in the patients’ serum.

Results:
Compared with glimepiride, linagliptin was able to significantly reduce the fasting blood glucose level (P = 0.039). Moreover, the expression level of miR-210 was positively correlated with fasting blood glucose level (r = 0.272, P = 0.011) and 2 h post-breakfast blood glucose level (r = 0.245, P = 0.023). The fasting insulin level was negatively correlated with the expression level of miR-210 (r = −0.224, P = 0.038). Also, the alanine transaminase (ALT) level (r = 0.438, P < 0.001) and ALT/aspartate aminotransferase ratio (r = 0.382, P < 0.001) were positively correlated with miR-210 expression.

Conclusions:
In summary, linagliptin was not significantly different from glimepiride in improving the hepatic and renal functions and in reducing the blood lipid level. miR-210 expression was linked to blood glucose and lipid levels and hepatic function, which indicates its role as a prognostic biomarker in the treatment of NAFLD with T2DM using linagliptin and glimepiride.