Clinical Efficacy and Body Composition Changes with Sodium Glucose Cotransporter 2 Inhibitor/Glucagon-like Peptide-1 Antagonist Combination Therapy in Patients with Type 2 Diabetes Mellitus-associated Nonalcoholic Fatty Liver Disease
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- Ishikawa Toru
- Department of Gastroenterology, Saiseikai Niigata Hospital, Japan
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- Terai Nanako
- Department of Radiographer, Saiseikai Niigata Hospital, Japan
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- Sato Ryo
- Department of Gastroenterology, Saiseikai Niigata Hospital, Japan
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- Jimbo Ryo
- Department of Gastroenterology, Saiseikai Niigata Hospital, Japan
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- Kobayashi Yuji
- Department of Gastroenterology, Saiseikai Niigata Hospital, Japan
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- Sato Toshifumi
- Department of Gastroenterology, Saiseikai Niigata Hospital, Japan
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- Iwanaga Akito
- Department of Gastroenterology, Saiseikai Niigata Hospital, Japan
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- Sano Tomoe
- Department of Gastroenterology, Saiseikai Niigata Hospital, Japan
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- Yokoyama Junji
- Department of Gastroenterology, Saiseikai Niigata Hospital, Japan
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- Honma Terasu
- Department of Gastroenterology, Saiseikai Niigata Hospital, Japan
抄録
<p>Objective Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) treatment guidelines recommend sodium glucose cotransporter 2 inhibitor (SGLT2I) and glucagon-like peptide-1 agonist (GLP-1A) therapy in patients with type 2 diabetes mellitus (T2DM). SGLT2I improves the pathological condition of NAFLD/NASH in T2DM patients. However, cases of rebound during long-term SGLT2I treatment have been reported. This study investigated the efficacy of SGLT2I and GLP-1A combination therapy in diabetic patients with NAFLD by examining changes in computed tomography (CT)-based body composition and clinical outcomes. </p><p>Methods Fifteen patients (5 men/10 women) with T2DM-associated NAFLD who had not responded to SGLT2I treatment and were being treated with GLP-1A combination therapy were included. Changes in the liver function, visceral adipose tissue index (VATI), and subcutaneous adipose tissue index (SATI) were compared using CT to evaluate the body composition. </p><p>Results SGLT2I significantly improved alanine aminotransferase (28.0 to 13.0 IU/L), alkaline phosphatase (250.0 to 77.0 IU/L), and gamma glutamyl transpeptidase (23.0 to 12.0 IU/L) levels. The body mass index (BMI) decreased from 25.7 to 25.2 kg/m2. A CT-based analysis showed a significant improvement in SATI (80.9 to 66.1, p=0.002), with no significant change in VATI (53.2 to 51.5). GLP-1A addition improved the BMI (25.2 to 23.5 kg/m2) and hemoglobin A1c (6.5% to 6.2%, p=0.001). A further analysis revealed additional improvement in SATI (66.1 to 56.6, p=0.007) and a significant decrease in VATI (51.5 to 48.3, p=0.001). </p><p>Conclusion SGLT2I and GLP-1A combination therapy improved the liver function, body composition, and glycemic control in diabetic patients with NAFLD/NASH, as well as SATI and VATI. The optimal timing of combination therapy remains to be determined. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine advpub (0), 2024
一般社団法人 日本内科学会
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詳細情報 詳細情報について
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- CRID
- 1390017655072366592
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- ISSN
- 13497235
- 09182918
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- Crossref
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- 抄録ライセンスフラグ
- 使用不可