Evolution of liver fibrosis in diabetic patients with NAFLD in a follow-up study: Hepatoprotective effects of sodium-glucose co-transporter-2 inhibitors - PubMed (original) (raw)

. 2024 Apr;56(4):551-558.

doi: 10.1016/j.dld.2023.09.023. Epub 2023 Oct 14.

Alessandro Mantovani 2, Annalisa Cespiati 3, Paolo Francione [ 4](#full-view-affiliation-4 "UO di Medicina, Azienda Ospedaliera "Card. G. Panico" di Tricase, Italy."), Gabriele Maffi 3, Elena Del Zanna 3, Claudio Maffeis 5, Antonio Colecchia 6, Nicola Passigato 7, Alberto Ferrarese 7, Caterina Daniela Cusumanu 7, Rosanna Villani 8, Emanuela Orsi 9, Valeria Grancini 9, Lorena Airaghi 10, Daniela Bignamini 10, Gaetano Serviddio 8, Giovanni Targher 11, Paola Dongiovanni 10, Silvia Fargion 12, Anna Ludovica Fracanzani 3

Affiliations

Evolution of liver fibrosis in diabetic patients with NAFLD in a follow-up study: Hepatoprotective effects of sodium-glucose co-transporter-2 inhibitors

Rosa Lombardi et al. Dig Liver Dis. 2024 Apr.

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.

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®.

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.

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.

Keywords: Fibroscan; Follow-up study; Hepatic steatosis; Liver stiffness measurement; Nonalcoholic fatty liver disease; Prospective; SGLT2 inhibitors; Type 2 diabetes.

Copyright © 2023 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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