Sodium-Glucose Cotransporter-2 Inhibitors Ameliorate Liver Enzyme Abnormalities in Korean Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease
Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are reported to reduce body fat in patients with type 2 diabetes mellitus (T2DM), and SGLT2i-induced weight reduction may help improve comorbid nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the potential benefit of SGLT2...
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Frontiers Media S.A.
2021-06-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.613389/full |
| _version_ | 1818899659338285056 |
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| author | Won Euh Soo Lim Soo Lim Jin-Wook Kim Jin-Wook Kim |
| author_facet | Won Euh Soo Lim Soo Lim Jin-Wook Kim Jin-Wook Kim |
| author_sort | Won Euh |
| collection | DOAJ |
| description | Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are reported to reduce body fat in patients with type 2 diabetes mellitus (T2DM), and SGLT2i-induced weight reduction may help improve comorbid nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the potential benefit of SGLT2is over other oral antidiabetic drugs (OADs) in patients with T2DM-associated NAFLD. We enrolled real-world Korean patients with T2DM-associated NAFLD in whom initial metformin therapy had been modified by stepwise addition of OAD(s) due to insufficient glucose control. Propensity score (PS) matching was used for the comparison of changes in clinical and biochemical parameters to balance potential covariates. Among the 765 enrolled patients, 663 patients received additional OADs other than SGLT2i and 102 patients received SGLT2i therapy. PS matching selected 150 and 100 patients from the control and the SGLT2i group, respectively. The SGLT2i group lost more weight than the control group at 6 months (mean –1.3 kg vs. 0.0 kg; P < 0.001). Alanine aminotransferase (ALT) levels also decreased more in the SGLT2i group at 3 (–11 U/L vs. –1 U/L), 6 (–12 U/L vs. –1 U/L), and 12 months (–14 U/L vs. –2 U/L) (all P < 0.05). Addition of SGLT2is was an independent predictor of ALT improvement in a multivariate logistic regression model (odds ratio 1.91; P = 0.016). Compared with other OADs, addition of SGLT2is was more effective in weight reduction and ALT improvement in patients with T2DM and comorbid NAFLD. |
| first_indexed | 2024-12-19T19:51:29Z |
| format | Article |
| id | doaj.art-63e5bb6025b74732901429cafdc2f6a3 |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-19T19:51:29Z |
| publishDate | 2021-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-63e5bb6025b74732901429cafdc2f6a32022-12-21T20:07:58ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-06-011210.3389/fendo.2021.613389613389Sodium-Glucose Cotransporter-2 Inhibitors Ameliorate Liver Enzyme Abnormalities in Korean Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver DiseaseWon Euh0Soo Lim1Soo Lim2Jin-Wook Kim3Jin-Wook Kim4Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South KoreaDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South KoreaSodium-glucose cotransporter-2 inhibitors (SGLT2is) are reported to reduce body fat in patients with type 2 diabetes mellitus (T2DM), and SGLT2i-induced weight reduction may help improve comorbid nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the potential benefit of SGLT2is over other oral antidiabetic drugs (OADs) in patients with T2DM-associated NAFLD. We enrolled real-world Korean patients with T2DM-associated NAFLD in whom initial metformin therapy had been modified by stepwise addition of OAD(s) due to insufficient glucose control. Propensity score (PS) matching was used for the comparison of changes in clinical and biochemical parameters to balance potential covariates. Among the 765 enrolled patients, 663 patients received additional OADs other than SGLT2i and 102 patients received SGLT2i therapy. PS matching selected 150 and 100 patients from the control and the SGLT2i group, respectively. The SGLT2i group lost more weight than the control group at 6 months (mean –1.3 kg vs. 0.0 kg; P < 0.001). Alanine aminotransferase (ALT) levels also decreased more in the SGLT2i group at 3 (–11 U/L vs. –1 U/L), 6 (–12 U/L vs. –1 U/L), and 12 months (–14 U/L vs. –2 U/L) (all P < 0.05). Addition of SGLT2is was an independent predictor of ALT improvement in a multivariate logistic regression model (odds ratio 1.91; P = 0.016). Compared with other OADs, addition of SGLT2is was more effective in weight reduction and ALT improvement in patients with T2DM and comorbid NAFLD.https://www.frontiersin.org/articles/10.3389/fendo.2021.613389/fulltype 2 diabetes mellitussodium-glucose cotransporter 2 (SGLT2) inhibitoralanine aminotransferasebody weightpropensity score (PS) matching (PSM) |
| spellingShingle | Won Euh Soo Lim Soo Lim Jin-Wook Kim Jin-Wook Kim Sodium-Glucose Cotransporter-2 Inhibitors Ameliorate Liver Enzyme Abnormalities in Korean Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease Frontiers in Endocrinology type 2 diabetes mellitus sodium-glucose cotransporter 2 (SGLT2) inhibitor alanine aminotransferase body weight propensity score (PS) matching (PSM) |
| title | Sodium-Glucose Cotransporter-2 Inhibitors Ameliorate Liver Enzyme Abnormalities in Korean Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease |
| title_full | Sodium-Glucose Cotransporter-2 Inhibitors Ameliorate Liver Enzyme Abnormalities in Korean Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease |
| title_fullStr | Sodium-Glucose Cotransporter-2 Inhibitors Ameliorate Liver Enzyme Abnormalities in Korean Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease |
| title_full_unstemmed | Sodium-Glucose Cotransporter-2 Inhibitors Ameliorate Liver Enzyme Abnormalities in Korean Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease |
| title_short | Sodium-Glucose Cotransporter-2 Inhibitors Ameliorate Liver Enzyme Abnormalities in Korean Patients With Type 2 Diabetes Mellitus and Nonalcoholic Fatty Liver Disease |
| title_sort | sodium glucose cotransporter 2 inhibitors ameliorate liver enzyme abnormalities in korean patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease |
| topic | type 2 diabetes mellitus sodium-glucose cotransporter 2 (SGLT2) inhibitor alanine aminotransferase body weight propensity score (PS) matching (PSM) |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2021.613389/full |
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