Nonalcoholic Fatty Liver Disease and Diabetes: Part II: Treatment

Kim, Kyung Soo; Lee, Byung Wan; Kim, Yong Jin; Lee, Dong Hoon; Soo, Bong; Park, Cheol‐Young

doi:10.4093/dmj.2019.0034

Cited by 43 publications

(76 citation statements)

References 112 publications

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“…In this meta-analysis, we found that compared with other OADs, SGLT2 inhibitors can significantly decrease ALT (-11.05 IU/L). Although pioglitazone has been shown to have a great effect on the improvement of liver function 6 , SGLT2 inhibitors resulted in an additional ALT reduction of 2.5 IU compared with pioglitazone in that study. SGLT2 inhibitors can also reduce AST (-1.11 IU/L); however, the reduction is slight and shows no statistical difference, considering the reason might be that AST is not a very specific indicator of fat liver and is susceptible to other factors.…”

Section: Discussionmentioning

confidence: 71%

“…Furthermore, the prevalence of NAFLD often accompanies various complications, such as cardiovascular adverse events, in patients with type 2 diabetes mellitus 5 , which is detrimental to the prognosis of those patients. Therefore, effective therapy for NAFLD is important for patients with type 2 diabetes mellitus 6 . Nowadays, although we have evidence that pioglitazone, an insulin sensitizer, can improve the function of the liver when it plays a hypoglycemic effect, it also has side-effects, such as the increase of subcutaneous fat tissue and bodyweight gain with edema 7 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of sodium–glucose cotransporter 2 inhibitors on non‐alcoholic fatty liver disease in patients with type 2 diabetes: A meta‐analysis of randomized controlled trials

Xing

Zhao

Dong

et al. 2020

J of Diabetes Invest

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Aims/Introduction Non‐alcoholic fatty liver disease (NAFLD) is increasingly common in patients with type 2 diabetes mellitus. Currently, some studies have found that sodium–glucose cotransporter 2 (SGLT2) inhibitors, a new hypoglycemic drug, can improve non‐alcoholic fatty liver in addition to its hypoglycemic effect. Thus, we undertook a meta‐analysis of randomized controlled trials to evaluate the efficacy of SGLT2 inhibitors on the treatment of NAFLD. Materials and Methods PubMed, Embase and the Cochrane Library were searched for randomized controlled trials of SGLT2 inhibitors in patients with NAFLD and type 2 diabetes mellitus up to 1 October 2019. Differences were expressed as weight mean difference (WMD) with 95% confidence interval (CI) for continuous outcomes. The I2 statistic was applied to evaluate the heterogeneity of studies. Results A total of six trials including 309 patients were selected into our meta‐analysis. SGLT2 inhibitors could reduce alanine aminotransferase (WMD −11.05 IU/L, 95% CI −19.85, −2.25, P = 0.01) and magnetic resonance imaging proton density fat fraction (WMD −2.07%, 95% CI −3.86, −0.28, P = 0.02). However, SGLT2 inhibitors did not reduce aspartate aminotransferase (WMD −1.11 IU/L, 95% CI −2.39, 0.17, P = 0.09). In addition, secondary outcomes, such as bodyweight and visceral fat area, were also reduced (WMD −1.62 kg, 95% CI −2.02, −1.23, P < 0.00001; WMD −19.98 cm2, 95% CI −27.18, −12.79, P < 0.00001, respectively). Conclusions SGLT2 inhibitors can significantly decrease alanine aminotransferase and liver fat, accompanied with weight loss, which might have a positive effect on fatty liver in patients with type 2 diabetes mellitus. The limitation is that the sample size of the studies was small. Therefore, more large randomized controlled trials specified on NAFLD are required to evaluate these results.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Effects of sodium–glucose cotransporter 2 inhibitors on non‐alcoholic fatty liver disease in patients with type 2 diabetes: A meta‐analysis of randomized controlled trials

Xing

Zhao

Dong

et al. 2020

J of Diabetes Invest

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“…In the present study 18 (34.62%) had normal BMI, 19 (36.54%) patients were overweight (25-30 Kg/m 2 ) and 15 (28.85%) were Obese (≥ 30 Kg/m 2 ). 6 Kyung-Soo Kim et al(2019), mentioned in his review article that Saroglitazar reduced alkaline phosphatase as well as triglyceride levels. 4 A review article by Kaul et al(2019), also stated that Saroglitazar was found effective in lowering ALT levels and improving fatty liver (evaluated by…”

Section: Discussionmentioning

confidence: 99%

“…Saroglitazar reduced alkaline phosphatase as well as triglyceride levels in patients with hypertriglyceridemia (>200 and <500 mg/dL) and type 2 diabetes mellitus (T2DM) in a three-arm phase III, 16-week prospective, multicenter, randomized, double-blind, placebo-controlled study. 4 Considering the association between insulin resistance, dyslipidemia and the development of NAFLD/NASH, saroglitazar could potentially benefit patients with NAFLD including those with borderline NASH. Therefore, the…”

Section: Introductionmentioning

confidence: 99%

An Investigator Initiated Prospective, Single Arm Observational Study to Evaluate the Safety and Efficacy of Saroglitazar 4 mg in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD)/Non- Alcoholic Steatohepatitis (NASH)

Hajare¹,

Gokak²,

Ghorpade³

et al. 2019

IJCMR

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Introduction: Saroglitazar is known to safely and effectively improve dyslipidemia by reducing triglyceride (TG), low density lipoprotein (LDL) cholesterol, very low-density lipoprotein (VLDL) cholesterol, non-high-density lipoprotein (non-HDL) cholesterol and increasing high density lipoprotein (HDL) cholesterol. In addition, saroglitazar can improve glycemic indices in diabetic patients by reducing fasting plasma glucose (FPG) and glycosylated haemoglobin (HbA1c). Aim of the study was to evaluate the hospital based clinic-pathological profile, diagnosis, treatment and follow up of Indian patients with Non-alcoholic fatty liver disease and to evaluate the safety and efficacy of Saroglitazar 4 mg in patients with Non-alcoholic fatty liver disease /Non-alcoholic Steatohepatitis in real life setting. Material and methods: This was an ongoing observational study with the sample size of 52 patients having Nonalcoholic fatty liver disease and dyslipidaemia with or without Type 2 Diabetes Mellitus and treatment follow up for a period of 1 year in the Department Of Gastroenterology. The data was collected from eligible patients who have been prescribed Saroglitazar 4 mg once daily in routine clinical practice. Primary endpoints were to see liver stiffness. Secondary endpoints were to measure serum alanine aminotransferase, aspartate aminotransferase level and Serum triglycerides level. Results: There was a significant decrease in Serum alanine aminotransferase (p <0.001), aspartate aminotransferase (p value < 0.001), triglycerides (p value <0.001) and triglycerides (p value 0.01), levels after the treatment as compared to the baseline. Conclusion: Saroglitazar treatment is effective and there is a significant difference in Serum alanine aminotransferase and aspartate aminotransferase, triglycerides and Liver Stiffness Measurement levels after treatment. The drug can be successfully administered for the treatment of Non-alcoholic fatty liver disease.

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“…NAFLD was previously considered an intra-hepatic phenotype of metabolic syndrome; however, it has since been revealed that NAFLD itself is an independent risk factor for various chronic diseases such as cardiovascular disease (CVD) [3], hypertension [4], diabetes [5,6], and chronic kidney disease [7]. In addition, as CVD is the most common cause of death in NAFLD patients, studies on the relationship between NAFLD and CVD and its mechanism have been actively conducted [8].…”

Section: Introductionmentioning

confidence: 99%

Fatty liver index and development of cardiovascular disease in Koreans without pre-existing cardiovascular disease: a large population-based study

Kim

Moon

Byun

et al. 2020

Preprint

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KEYWORDS 2 cardiovascular disease, mortality, non-alcoholic fatty liver disease, fatty liver index 3 Abstract Background Despite the known association between non-alcoholic fatty liver disease (NAFLD) and cardiovascular disease (CVD), it remains uncertain whether NAFLD predicts future CVD events, especially CVD mortality. We evaluated the relationship between fatty liver index (FLI), a validated marker of NAFLD, and risk of major adverse cardiac events (MACE) in a large population-based study.Methods We identified 3,011,588 subjects without a history of CVD who underwent health examinations from 2009 to 2011 in the Korean National Health Insurance System cohort. The primary endpoint was a composite of cardiovascular deaths, non-fatal myocardial infarction (MI), and ischemic stroke. Cox proportional hazards regression analysis was performed to assess the independent association between FLI and the primary endpoint.Results During the median follow-up of 6 years, there were 46,010 cases of MACE (7,148 cases of cardiovascular death, 16,574 non-fatal MI, and 22,228 ischemic stroke). There was a linear association between higher FLI values and higher incidence of the primary endpoint. In the multivariable models adjusted for factors including body weight and cholesterol levels, the hazard ratio (95% CIs) for the primary endpoint comparing the highest vs. lowest quartiles of FLI was 1.99(1.91-2.07). The corresponding odds ratios (95% CIs) for cardiovascular death, non-fetal MI, and ischemic stroke were 1.98 (1.9-2.06), 2.16 (2.01-2.31), and 2.01 (1.90-2.13), respectively. The results were similar when we stratified analysis by age, sex, dyslipidemia medication, obesity, diabetes, and hypertension.Conclusions Our findings indicate that FLI, a surrogate marker of NAFLD, has prognostic value for

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Nonalcoholic Fatty Liver Disease and Diabetes: Part II: Treatment

Cited by 43 publications

References 112 publications

Effects of sodium–glucose cotransporter 2 inhibitors on non‐alcoholic fatty liver disease in patients with type 2 diabetes: A meta‐analysis of randomized controlled trials

Effects of sodium–glucose cotransporter 2 inhibitors on non‐alcoholic fatty liver disease in patients with type 2 diabetes: A meta‐analysis of randomized controlled trials

An Investigator Initiated Prospective, Single Arm Observational Study to Evaluate the Safety and Efficacy of Saroglitazar 4 mg in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD)/Non- Alcoholic Steatohepatitis (NASH)

Fatty liver index and development of cardiovascular disease in Koreans without pre-existing cardiovascular disease: a large population-based study

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