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Evolution of liver fibrosis in diabetic patients with NAFLD in a follow-up study: Hepatoprotective effects of sodium-glucose co-transporter-2 inhibitors.
- Source :
-
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2024 Apr; Vol. 56 (4), pp. 551-558. Date of Electronic Publication: 2023 Oct 14. - Publication Year :
- 2024
-
Abstract
- Background and Aims: Patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are at high risk of hepatic fibrosis. To prospectively evaluate changes in fibrosis in diabetic patients with NAFLD, predisposing factors and sodium glucose cotransporter 2 inhibitors (SGLT2i) influence.<br />Methods: 237 T2DM outpatients (mean age 67 ± 9 years, 54% male) were enrolled and re-evaluated after 52 ± 10 months. At baseline and follow-up NAFLD and liver fibrosis (LSM) were detected by ultrasonography and Fibroscan®.<br />Results: During follow-up an increase in LSM (6.0 ± 2.8 vs 5.8 ± 2.7 kPa, p = 0.02) and in the prescription of SGLT2i (20% vs 6%, p<0.001) was registered, despite stability of diabetic control. LSM worsened in 133(56%) subjects, 92 (39%) with worsening >10% from baseline. Patients with worsening versus non worsening of LSM had higher prevalence of increase in BMI during follow-up (45% vs 32%, p = 0.06) and lower SGLT2i prescription (15% vs 27%, p = 0.034). In multivariate analysis use of SGLT2-inhibitors at follow-up reduced the risk of LSM worsening (HR 0.34, 95% CI 0.13-0.88), even when considered>10% from baseline.<br />Conclusions: A high prevalence of fibrosis progression was observed in diabetic subjects with NAFLD over a nearly 5-years follow up and SGLT2-inhibitors seem to reduce the risk of worsening of liver stiffness.<br />Competing Interests: Declaration of Competing Interest None declared.<br /> (Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)
- Subjects :
- Humans
Male
Middle Aged
Aged
Female
Follow-Up Studies
Liver pathology
Sodium-Glucose Transporter 2
Liver Cirrhosis epidemiology
Fibrosis
Glucose
Sodium
Non-alcoholic Fatty Liver Disease complications
Non-alcoholic Fatty Liver Disease drug therapy
Non-alcoholic Fatty Liver Disease epidemiology
Sodium-Glucose Transporter 2 Inhibitors therapeutic use
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 drug therapy
Diabetes Mellitus, Type 2 epidemiology
Elasticity Imaging Techniques
Subjects
Details
- Language :
- English
- ISSN :
- 1878-3562
- Volume :
- 56
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
- Publication Type :
- Academic Journal
- Accession number :
- 37845152
- Full Text :
- https://doi.org/10.1016/j.dld.2023.09.023