4.3 Article

Favorable effect of sodium-glucose cotransporter 2 inhibitor, dapagliflozin, on non-alcoholic fatty liver disease compared with pioglitazone

Journal

JOURNAL OF DIABETES INVESTIGATION
Volume 12, Issue 7, Pages 1272-1277

Publisher

WILEY
DOI: 10.1111/jdi.13457

Keywords

Fatty liver; Sodium– glucose cotransporter 2 inhibitor; Type 2 diabetes

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Dapagliflozin may be more beneficial than pioglitazone for patients with NAFLD, and improvements in FLI are closely related to glycemic control.
Aims/Introduction Sodium-glucose cotransporter 2 inhibitors, as well as thiazolidines, suppress nonalcoholic fatty liver disease (NAFLD); however, few comparative studies have been reported. Dapagliflozin has shown non-inferiority compared with pioglitazone for glycemic control, and superiority regarding weight reduction in patients with type 2 diabetes. We carried out a secondary analysis for the favorable effects of sodium-glucose cotransporter inhibitors for NAFLD. Materials and Methods In this multicenter, open-label, prospective, randomized, parallel-group comparison trial, patients taking pioglitazone for >= 12 weeks were randomly switched to dapagliflozin or continued pioglitazone for a further 24 weeks. The fatty liver index (FLI), consisting of body mass index, triglycerides, waist circumference and gamma-glutamyl transpeptidase, was used for the evaluation of NAFLD. Results A total of 53 participants with NAFLD (27 dapagliflozin; 26 pioglitazone) were included in this analysis. FLI decreased significantly in the dapagliflozin group (48.7 +/- 23.4 to 42.1 +/- 23.9) compared with the pioglitazone group (49.0 +/- 26.1 to 51.1 +/- 25.8; P < 0.01). Multiple linear regression analysis showed that the changes in FLI had a significantly positive correlation with changes in glycated hemoglobin (P = 0.03) and insulin level (P < 0.01) in the dapagliflozin group. Conclusion Dapagliflozin might be more beneficial than pioglitazone in patients with NAFLD. Improvements in FLI would be closely related to glycemic control.

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