1. Non-alcoholic fatty liver disease risk with GLP-1 receptor agonists and SGLT-2 inhibitors in type 2 diabetes: a nationwide nested case-control study.
- Author
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Chang KC, Kuo FC, Yang CY, Yang CT, Ou HT, and Kuo S
- Subjects
- Humans, Male, Middle Aged, Female, Risk Factors, Taiwan epidemiology, Aged, Risk Assessment, Incidence, Treatment Outcome, Time Factors, Hypoglycemic Agents therapeutic use, Hypoglycemic Agents adverse effects, Adult, Incretins therapeutic use, Incretins adverse effects, Case-Control Studies, Glucagon-Like Peptide-1 Receptor Agonists, Non-alcoholic Fatty Liver Disease epidemiology, Non-alcoholic Fatty Liver Disease diagnosis, Non-alcoholic Fatty Liver Disease drug therapy, Non-alcoholic Fatty Liver Disease blood, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 epidemiology, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 blood, Sodium-Glucose Transporter 2 Inhibitors therapeutic use, Sodium-Glucose Transporter 2 Inhibitors adverse effects, Glucagon-Like Peptide-1 Receptor agonists, Databases, Factual
- Abstract
Background: Non-alcoholic fatty liver diseases (NAFLDs)/non-alcoholic steatohepatitis (NASH) are the most common liver disorders among patients with type 2 diabetes. Newer classes of glucose-lowering agents (GLAs), such as glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 inhibitors (SGLT2is), have been shown to improve liver-related biomarkers. However, their effects on the development of NAFLD/NASH remain inconclusive., Methods: A nested case-control study was conducted using Taiwan's National Health Insurance Research Database for 2011-2018. Patients aged ≥ 40 years, diagnosed with type 2 diabetes, having stable non-insulin GLA use, and without NAFLD/NASH history were included. Patients with incident NAFLD/NASH were matched up to 10 randomly sampled controls based on individual's age, gender, cohort entry date, type 2 diabetes diagnosis date, and disease risk score. Conditional logistic regression analyses were employed to estimate the association between liver risk and treatment exposure. Dose-response analysis was also performed., Results: There were 621,438 study patients included for analysis. During 1.8 years of median follow-up, the incidence of NAFLD/NASH was 2.7 per 1000 person-years. After matching, 5,730 incident NAFLD cases (mean age: 57.6 years, male: 53.2%) and 45,070 controls (57.7 years, 52.7%) were identified. Using GLP-1RAs or SGLT2is was associated with an insignificantly lower NAFLD/NASH risk (i.e., odds ratios [95% CIs]: 0.84 [0.46-1.52] and 0.85 [0.63-1.14], respectively) and increased cumulative SGLT2i doses were significantly associated with a reduced NAFLD/NASH risk (0.61 [0.38-0.97])., Conclusion: GLP-1RA and SGLT2i therapies in type 2 diabetes patients might prevent NAFLD/NASH development, with a significantly lower risk related to greater treatment exposure., (© 2024. The Author(s).)
- Published
- 2024
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