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
  • Masanori Atsukawa
    Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
  • Akihito Tsubota
    Core Research Facilities for Basic Science, Research Center for Medical Sciences,The Jikei University School of Medicine,Tokyo,Japan
  • Shigeru Mikami
    Division of Gastroenterology, Department of Internal Medicine,Kikkoman General Hospital,Miyazaki Noda,Japan
  • Uojima Haruki
    Department of Gastroenterology, Internal Medicine,Kitasato University School of Medicine,Sagamihara,Japan
  • Keiichiro Yoshikata
    Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
  • Hiroki Ono
    Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
  • Tadamichi Kawano
    Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
  • Yuji Yoshida
    Division of Gastroenterology,Nippon Medical School Chiba Hokusoh Hospital,Chiba,Japan
  • Tomohide Tanabe
    Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
  • Tomomi Okubo
    Division of Gastroenterology,Nippon Medical School Chiba Hokusoh Hospital,Chiba,Japan
  • Korenobu Hayama
    Division of Gastroenterology,Nippon Medical School Chiba Hokusoh Hospital,Chiba,Japan
  • Ai Nakagawa‐Iwashita
    Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
  • Norio Itokawa
    Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
  • Chisa Kondo
    Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
  • Keiko Kaneko
    Division of Gastroenterology and Hepatology,Nippon Medical School,Tokyo,Japan
  • Mototsugu Nagao
    Division of Endocrinology, Diabetes and Metabolism,Nippon Medical School,Tokyo,Japan
  • Kyoko Inagaki
    Division of Endocrinology, Diabetes and Metabolism,Nippon Medical School,Tokyo,Japan
  • Izumi Fukuda
    Division of Endocrinology, Diabetes and Metabolism,Nippon Medical School,Tokyo,Japan
  • Hitoshi Sugihara
    Division of Endocrinology, Diabetes and Metabolism,Nippon Medical School,Tokyo,Japan
  • 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

  • Hepatology Communications

    Hepatology Communications 6 (11), 3073-3082, 2022-08-30

    Ovid Technologies (Wolters Kluwer Health)

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