Effects of sodium glucose cotransporter 2 inhibitors and pioglitazone on FIB‐4 index in metabolic‐associated fatty liver disease

Mino, Masaaki; Kakazu, Eiji; Sano, Akitoshi; Katsuyama, Hisayuki; Hakoshima, Mariko; Yanai, Hidekatsu; Aoki, Yoshihiko; Imamura, Masatoshi; Yamazoe, Taiji; Mori, Taizo; Yoshio, Sachiyo; Inoue, Jun; Masamune, Atsushi; Kanto, Tatsuya

doi:10.1111/hepr.13898

Cited by 9 publications

(5 citation statements)

References 33 publications

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“…In our study, 91% of the patients also took SGLT2 inhibitors, which have been reported to improve glycemia, lipid profile and obesity, as well as MASLD [37,49]. Adding onceweekly semaglutide to SGLT2 inhibitors resulted in greater reductions in body weight and HbA1c and was generally well tolerated [50].…”

Section: Discussionmentioning

confidence: 58%

Effects of Once-Weekly Semaglutide on Cardiovascular Risk Factors and Metabolic Dysfunction-Associated Steatotic Liver Disease in Japanese Patients with Type 2 Diabetes: A Retrospective Longitudinal Study Based on Real-World Data

Katsuyama,

Hakoshima,

Kaji

et al. 2024

Biomedicines

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Once-weekly semaglutide is a widely used glucagon-like peptide-1 receptor agonist (GLP-1RA) used for the treatment of type 2 diabetes (T2D). In clinical trials, semaglutide improved glycemic control and obesity, and reduced major cardiovascular events. However, the reports are limited on its real-world efficacy relating to various metabolic factors such as dyslipidemia or metabolic dysfunction-associated steatotic liver disease (MASLD) in Asian patients with T2D. In our retrospective longitudinal study, we selected patients with T2D who were given once-weekly semaglutide and compared metabolic parameters before and after the start of semaglutide. Seventy-five patients were eligible. HbA1c decreased significantly, by 0.7–0.9%, and body weight by 1.4–1.7 kg during the semaglutide treatment. Non-HDL cholesterol decreased significantly at 3, 6 and 12 months after the initiation of semaglutide; LDL cholesterol decreased at 3 and 6 months; and HDL cholesterol increased at 12 months. The effects on body weight, HbA1c and lipid profile were pronounced in patients who were given semaglutide as a first GLP-1RA (GLP-1R naïve), whereas improvements in HbA1c were also observed in patients who were given semaglutide after being switched from other GLP-1RAs. During a 12-month semaglutide treatment, the hepatic steatosis index (HSI) tended to decrease. Moreover, a significant decrease in the AST-to-platelet ratio index (APRI) was observed in GLP-1RA naïve patients. Our real-world study confirmed the beneficial effects of once-weekly semaglutide, namely, improved body weight, glycemic control and atherogenic lipid profile. The beneficial effects on MASLD were also suggested.

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Section: Discussionmentioning

confidence: 58%

Effects of Once-Weekly Semaglutide on Cardiovascular Risk Factors and Metabolic Dysfunction-Associated Steatotic Liver Disease in Japanese Patients with Type 2 Diabetes: A Retrospective Longitudinal Study Based on Real-World Data

Katsuyama,

Hakoshima,

Kaji

et al. 2024

Biomedicines

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“…We also retrospectively studied 568 patients with MASLD and type 2 diabetes. At 96 weeks, the mean FIB-4 index had significantly decreased (from 1.79 ± 1.10 to 1.56 ± 0.75) in the SGLT2i group but not in the pioglitazone group [112]. Another marker for hepatic fibrosis, the aspartate aminotransferase-to-platelet ratio index (APRI), significantly decreased in both groups.…”

Section: Effects Of Sglt2i On Liver Enzymes Hepatic Steatosis and Fib...mentioning

confidence: 93%

Metabolic-Dysfunction-Associated Steatotic Liver Disease—Its Pathophysiology, Association with Atherosclerosis and Cardiovascular Disease, and Treatments

Yanai,

Adachi,

Hakoshima

et al. 2023

IJMS

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Metabolic-dysfunction-associated steatotic liver disease (MASLD) is a chronic liver disease that affects more than a quarter of the global population and whose prevalence is increasing worldwide due to the pandemic of obesity. Obesity, impaired glucose metabolism, high blood pressure and atherogenic dyslipidemia are risk factors for MASLD. Therefore, insulin resistance may be closely associated with the development and progression of MASLD. Hepatic entry of increased fatty acids released from adipose tissue, increase in fatty acid synthesis and reduced fatty acid oxidation in the liver and hepatic overproduction of triglyceride-rich lipoproteins may induce the development of MASLD. Since insulin resistance also induces atherosclerosis, the leading cause for death in MASLD patients is cardiovascular disease. Considering that the development of cardiovascular diseases determines the prognosis of MASLD patients, the therapeutic interventions for MASLD should reduce body weight and improve coronary risk factors, in addition to an improving in liver function. Lifestyle modifications, such as improved diet and increased exercise, and surgical interventions, such as bariatric surgery and intragastric balloons, have shown to improve MASLD by reducing body weight. Sodium glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) have been shown to improve coronary risk factors and to suppress the occurrence of cardiovascular diseases. Both SGLT2i and GLP-1 have been reported to improve liver enzymes, hepatic steatosis and fibrosis. We recently reported that the selective peroxisome proliferator-activated receptor-alpha (PPARα) modulator pemafibrate improved liver function. PPARα agonists have multiple anti-atherogenic properties. Here, we consider the pathophysiology of MASLD and the mechanisms of action of such drugs and whether such drugs and the combination therapy of such drugs could be the treatments for MASLD.

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“…There is no specific pharmacotherapy approved solely for the treatment of MAFLD. However, pioglitazone ad SGLT2 inhibitors have been studied for their potential benefits in managing MAFLD [ 90 , 91 ].…”

Section: Clinical Consequences Of Male Obesitymentioning

confidence: 99%

Clinical and Therapeutic Implications of Male Obesity

Lenart-Lipińska,

Łuniewski,

Szydełko

et al. 2023

JCM

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The prevalence of obesity, a disorder linked to numerous comorbidities and metabolic complications, has recently increased dramatically worldwide and is highly prevalent in men, even at a young age. Compared to female patients, men with obesity more frequently have delayed diagnosis, higher severity of obesity, increased mortality rate, and only a minority of obese male patients are successfully treated, including with bariatric surgery. The aim of this review was to present the current state of knowledge about the clinical and therapeutic implications of obesity diagnosed in males.

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Effects of sodium glucose cotransporter 2 inhibitors and pioglitazone on FIB‐4 index in metabolic‐associated fatty liver disease

Cited by 9 publications

References 33 publications

Effects of Once-Weekly Semaglutide on Cardiovascular Risk Factors and Metabolic Dysfunction-Associated Steatotic Liver Disease in Japanese Patients with Type 2 Diabetes: A Retrospective Longitudinal Study Based on Real-World Data

Effects of Once-Weekly Semaglutide on Cardiovascular Risk Factors and Metabolic Dysfunction-Associated Steatotic Liver Disease in Japanese Patients with Type 2 Diabetes: A Retrospective Longitudinal Study Based on Real-World Data

Metabolic-Dysfunction-Associated Steatotic Liver Disease—Its Pathophysiology, Association with Atherosclerosis and Cardiovascular Disease, and Treatments

Clinical and Therapeutic Implications of Male Obesity

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