Open AccessFavorable effect of sodium–glucose cotransporter 2 inhibitor, dapagliflozin, on non‐alcoholic fatty liver disease compared with pioglitazone
Author(s) -
Cho Kyu Yong,
Nakamura Akinobu,
Omori Kazuno,
Takase Takahiro,
Miya Aika,
Yamamoto Kohei,
Nomoto Hiroshi,
Kameda Hiraku,
Taneda Shinji,
Kurihara Yoshio,
Aoki Shin,
Atsumi Tatsuya,
Miyoshi Hideaki
Publication year - 2021
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.13457
Subject(s) - pioglitazone , dapagliflozin , medicine , nonalcoholic fatty liver disease , type 2 diabetes , endocrinology , fatty liver , diabetes mellitus , glycemic , glycated hemoglobin , body mass index , gastroenterology , insulin , disease
Aims/Introduction Sodium–glucose cotransporter 2 inhibitors, as well as thiazolidines, suppress nonalcoholic fatty liver disease (NAFLD); however, few comparative studies have been reported. Dapagliflozin has shown non‐inferiority compared with pioglitazone for glycemic control, and superiority regarding weight reduction in patients with type 2 diabetes. We carried out a secondary analysis for the favorable effects of sodium–glucose cotransporter inhibitors for NAFLD. Materials and Methods In this multicenter, open‐label, prospective, randomized, parallel‐group comparison trial, patients taking pioglitazone for ≥12 weeks were randomly switched to dapagliflozin or continued pioglitazone for a further 24 weeks. The fatty liver index (FLI), consisting of body mass index, triglycerides, waist circumference and γ‐glutamyl transpeptidase, was used for the evaluation of NAFLD. Results A total of 53 participants with NAFLD (27 dapagliflozin; 26 pioglitazone) were included in this analysis. FLI decreased significantly in the dapagliflozin group (48.7 ± 23.4 to 42.1 ± 23.9) compared with the pioglitazone group (49.0 ± 26.1 to 51.1 ± 25.8; P < 0.01). Multiple linear regression analysis showed that the changes in FLI had a significantly positive correlation with changes in glycated hemoglobin ( P = 0.03) and insulin level ( P < 0.01) in the dapagliflozin group. Conclusion Dapagliflozin might be more beneficial than pioglitazone in patients with NAFLD. Improvements in FLI would be closely related to glycemic control.