Effect of Dapagliflozin on Type 2 Diabetes Mellitus With Nonalcoholic Fatty Liver Disease: A Single-Center Survey

Abstract

IntroductionNonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, with a global prevalence of 20%-40%. Approximately 40%-60% of patients with type 2 diabetes mellitus (DM2) experience NAFLD; out of which 20%-40% cases may have higher severity. Due to the scarcity of available reports from the eastern part of India, we aimed to evaluate the effects of dapagliflozin, a sodium-glucose cotransporter-2 inhibitor used in these types of cases. Material and methodsThe study included consecutive patients with DM2 and NAFLD, treated with dapagliflozin at 10 mg daily for six months. All patients underwent detailed anthropometric, biochemical, abdominal ultrasonography, and transient elastography studies at baseline and after therapy as well as a comparative analysis. ResultsIn the 100 patients included in our study, the male patients outnumbered the female patients (male-tofemale ratio, 4.27:-1) and the mean age at presentation was 44.11 ± 8.24 years. The mean body mass index significantly decreased over the course of the therapy, from 27.31± 1.87 kg/m 2 at baseline to 26.21 ± 1.51 kg/m 2 after the therapy. The patients' transaminitis, dyslipidemia, and glycemic status significantly improved over the course of the therapy. We also observed significant (p < 0.05) improvement in hepatic steatosis by the end of the treatment. Although transient elastography by FibroScan-measured hepatic fibrosis score (Echosens, Paris, France) significantly decreased from 6.95 ± 1.42 to 6 ± 1.44 kPa, hepatic fibrosis did not improve significantly (p ≥ 0.05) following therapy. ConclusionAlthough dapagliflozin improved body mass index, transaminitis, dyslipidemia, glycemic status, and hepatic steatosis, it had a minimal effect on hepatic fibrosis.

The determination of the comparative effect of Ertugliflozin, Pioglitazone, and Metformin on patients of non-alcoholic fatty liver disease in type 2 diabetes mellitus.

“…resistance and hepatic steatosis(Das et al, 2021;Leiter et al, 2015). In our study, HOMA IR depiction proved the decrease of insulin resistance in pioglitazone patients of NAFLD (P = 0.001).…”

“…The other study mentioned that in the patients treated with dapagli ozin, their LSM was improved signi cantly (Das et al, 2021).…”

“…In most studies, there are no signi cant changes in liver brosis (Blanco-Grau et al, 2021).While in some studies, the FIB-4 index was signi cantly decreased(Kumari et al, 2021). A study reported that SGLT2 inhibitors notably decrease the FIB-4 index(Das et al, 2021). In another research, the APRI index was signi cantly decreased in the pioglitazone group(Lavynenko et al, 2022…”