Antifibrotic effect and long‐term outcome of SGLT2 inhibitors in patients with NAFLD complicated by diabetes mellitus
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- Taeang Arai
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
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- Masanori Atsukawa
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
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- Akihito Tsubota
- Core Research Facilities for Basic Science, Research Center for Medical Sciences,The Jikei University School of Medicine,Tokyo,Japan
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- Shigeru Mikami
- Division of Gastroenterology, Department of Internal Medicine,Kikkoman General Hospital,Miyazaki Noda,Japan
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- Uojima Haruki
- Department of Gastroenterology, Internal Medicine,Kitasato University School of Medicine,Sagamihara,Japan
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- Keiichiro Yoshikata
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
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- Hiroki Ono
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
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- Tadamichi Kawano
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
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- Yuji Yoshida
- Division of Gastroenterology,Nippon Medical School Chiba Hokusoh Hospital,Chiba,Japan
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- Tomohide Tanabe
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
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- Tomomi Okubo
- Division of Gastroenterology,Nippon Medical School Chiba Hokusoh Hospital,Chiba,Japan
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- Korenobu Hayama
- Division of Gastroenterology,Nippon Medical School Chiba Hokusoh Hospital,Chiba,Japan
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- Ai Nakagawa‐Iwashita
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
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- Norio Itokawa
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
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- Chisa Kondo
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
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- Keiko Kaneko
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
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- Mototsugu Nagao
- Division of Endocrinology, Diabetes and Metabolism,Nippon Medical School,Tokyo,Japan
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- Kyoko Inagaki
- Division of Endocrinology, Diabetes and Metabolism,Nippon Medical School,Tokyo,Japan
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- Izumi Fukuda
- Division of Endocrinology, Diabetes and Metabolism,Nippon Medical School,Tokyo,Japan
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- Hitoshi Sugihara
- Division of Endocrinology, Diabetes and Metabolism,Nippon Medical School,Tokyo,Japan
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- Katsuhiko Iwakiri
- Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
抄録
<jats:title>Abstract</jats:title> <jats:p>The aim of this retrospective multicenter study was to clarify the antifibrotic effect and long‐term outcome of sodium glucose cotransporter 2 inhibitors (SGLT2‐Is) in patients with nonalcoholic fatty liver disease (NAFLD) complicated by type 2 diabetes mellitus (T2DM). Of the 1262 consecutive patients with T2DM who recently received SGLT2‐Is, 202 patients with NAFLD had been receiving SGLT2‐Is for more than 48 weeks and were subjected to this analysis. Furthermore, 109 patients who had been on SGLT2‐I therapy for more than 3 years at the time of analysis were assessed for the long‐term effects of SGLT2‐Is. Significant decreases in body weight, liver transaminases, plasma glucose, hemoglobin A1c, and Fibrosis‐4 (FIB‐4) index were found at week 48. Overall, the median value of FIB‐4 index decreased from 1.42 at baseline to 1.25 at week 48 (<jats:italic toggle="yes">p</jats:italic> < 0.001). In the low‐risk group (FIB‐4 index < 1.3), there was no significant change in the FIB‐4 index. In the intermediate‐risk (≥1.3 and <2.67) and high‐risk (≥2.67) groups, the median levels significantly decreased from 1.77 and 3.33 at baseline to 1.58 and 2.75 at week 48, respectively (<jats:italic toggle="yes">p</jats:italic> < 0.001 for both). Improvements in body weight, glucose control, liver transaminases, and FIB‐4 index were found at 3 years of SGLT2‐I treatment. In the intermediate‐risk and high‐risk groups (≥1.3 FIB‐4 index), the FIB‐4 index maintained a significant reduction from baseline throughout the 3 years of treatment. <jats:italic toggle="yes">Conclusion:</jats:italic> This study showed that SGLT2‐Is offered a favorable effect on improvement in FIB‐4 index as a surrogate marker of liver fibrosis in patient with NAFLD complicated by T2DM, especially those with intermediate and high risks of advanced fibrosis, and this antifibrotic effect is sustained for the long term.</jats:p>
収録刊行物
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- Hepatology Communications
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Hepatology Communications 6 (11), 3073-3082, 2022-08-30
Ovid Technologies (Wolters Kluwer Health)