Highlights
- •Sodium-glucose cotransporter 2 (SGLT2) inhibitors showed significant reductions in fatty liver index (FLI) and its components compared to dipeptidyl peptidase 4 (DPP4) inhibitors in type 2 diabetes patients.
- •We further analyzed the change in FLI according to drug adherence measured by the medication possession ratio, and the change increased cumulatively with the duration of drug use.
- •We suggest that SGLT2 inhibitors may have beneficial effects in reducing the prevalence of nonalcoholic fatty liver disease in type 2 diabetes.
Abstract
Aims
This study was to determine the association between sodium-glucose cotransporter 2
inhibitors (SGLT2i) and nonalcoholic fatty liver disease (NAFLD) in type 2 diabetes.
Methods
We used data from the Korean National Health Insurance Service from 2014 to 2017.
New drug users were screened, dipeptidyl peptidase 4 inhibitors (DPP4i) were set as
the active comparator, and the differences between the two groups were corrected through
propensity score matching. NAFLD was evaluated by the fatty liver index (FLI), which
was calculated using body mass index, waist circumference, triglycerides, and gamma
glutamyl peptidase.
Results
After 1:1 matching, 25,371 patients in each group who received medication for an average
of 299 days were analyzed. Despite similar baseline FLI of each group, the FLI of
the SGLT2i users was 44.4 ± 26.7 and the FLI of the DPP4i users was 48.9 ± 27.3 (P
value < 0.001) after treatment. SGLT2i showed more significant decrements than DPP4i
in all components of FLI. The more the adherence to the SGLT2i increased, the greater
the decrease in FLI.
Conclusions
SGLT2i showed a significant reduction in FLI and its components. We suggest that SGLT2i
may have beneficial effects in reducing the prevalence of NAFLD in type 2 diabetes.
Keywords
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Article info
Publication history
Published online: November 25, 2022
Accepted:
November 21,
2022
Received in revised form:
November 2,
2022
Received:
July 11,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
