SGLT-2 inhibitors in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus: A systematic review

Raj, Henith; Durgia, Harsh; Palui, Rajan; Kamalanathan, Sadishkumar; Selvarajan, Sandhiya; Kar, Sitanshu Sekhar; Sahoo, Jayaprakash

doi:10.4239/wjd.v10.i2.114

Cited by 71 publications

(71 citation statements)

References 39 publications

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“…A systematic review [151] assessed the effect of SGLT2 inhibitors on liver enzymes in patients with T2D and NAFLD. Data from eight studies (04 RCTs and 04 observational studies) lasting at least 12 weeks were extracted.…”

Section: Sglt2 Inhibitorsmentioning

confidence: 99%

NAFLD as a continuum: from obesity to metabolic syndrome and diabetes

Godoy-Matos

Júnior

Valério

2020

Diabetol Metab Syndr

435

287

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Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) has been increasing rapidly. It is nowadays recognized as the most frequent liver disease, affecting a quarter of global population and regularly coexisting with metabolic disorders such as type 2 diabetes, hypertension, obesity, and cardiovascular disease. In a more simplistic view, NAFLD could be defined as an increase in liver fat content, in the absence of secondary cause of steatosis. In fact, the clinical onset of the disease is a much more complex process, closely related to insulin resistance, limited expandability and dysfunctionality of adipose tissue. A fatty liver is a main driver for a new recognized liver-pancreatic α-cell axis and increased glucagon, contributing to diabetes pathophysiology. Main text: This review will focus on the clinical and pathophysiological connections between NAFLD, insulin resistance and type 2 diabetes. We reviewed non-invasive methods and several scoring systems for estimative of steatosis and fibrosis, proposing a multistep process for NAFLD evaluation. We will also discuss treatment options with a more comprehensive view, focusing on the current available therapies for obesity and/or type 2 diabetes that impact each stage of NAFLD. Conclusion: The proper understanding of NAFLD spectrum-as a continuum from obesity to metabolic syndrome and diabetes-may contribute to the early identification and for establishment of targeted treatment.

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Section: Sglt2 Inhibitorsmentioning

confidence: 99%

NAFLD as a continuum: from obesity to metabolic syndrome and diabetes

Godoy-Matos

Júnior

Valério

2020

Diabetol Metab Syndr

435

287

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“…Statin and n-3 polyunsaturated fatty acids: There are no data to support their use specifically for NASH. SGLT-2 inhibitors: These drugs improve the serum liver enzymes value and reduce hepatic steatosis and fibrosis in type 2 diabetes patients with NAFLD [123]. Therefore use of SGLT2-inhibitors in type 2 diabetes patients with NAFLD is promising.…”

Section: Emerging Genetic Biomarkers For Diagnosis Of Different Stagementioning

confidence: 99%

Recent advances in non-invasive diagnosis and medical management of non-alcoholic fatty liver disease in adult

Paul

2020

Egypt Liver Journal

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Background: Number of non-alcoholic fatty liver disease (NAFLD) cases is increasing over time due to alteration of food habit, increase incidence of metabolic syndrome, and lack of exercise. Liver biopsy is the test for diagnosis and staging of NAFLD, but nowadays several biochemical markers, scoring systems, and imaging studies are available to diagnose and stage NAFLD which is linked to end-stage liver disease, hepatocellular cancer, and elevated cardiovascular-and cancer-related morbidity and mortality. Therefore urgent diagnosis and management are required to avoid complications related to NAFLD. This review summarizes recent advances in diagnosis and medical management of non-alcoholic fatty liver disease. Main text: Recently published studies from PubMed, Red Cross, Copernicus, and also various previous studies were reviewed. We have discussed various non-invasive methods for detection of non-alcoholic fatty liver disease, non-alcoholic steatohepatitis (NASH), and hepatic fibrosis. Non pharmacological therapies for NAFLD, indications, and approved medications for NAFLD and other commonly used non-approved medications have been discussed in this review article. Conclusions: Multiple non-invasive tests are available for diagnosis of NAFLD, and its different stages however gold standard test is liver biopsy. NALFD without NASH and significant fibrosis is treated by lifestyle modifications which include moderate to vigorous exercise and diet modification. To improve hepatic steatosis, minimum of 3-5% of body weight loss is necessary, but > 7-10% weight reductions is required for histological improvement in NASH and fibrosis. Pharmacotherapy is indicated when patient is having NASH with significant fibrosis.

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“…By inhibiting SGLT‐2, these agents decrease renal reabsorption of glucose and increase its excretion. Despite this unique mechanism, animal studies have shown that in addition to improving glycemic control, SGLT‐2 inhibitors also decrease hepatic fat perhaps through increase in glucagon levels …”

Section: Treatment Optionsmentioning

confidence: 99%

“…A recent meta‐analysis noted that 8 studies, including a total of 214 patients, had evaluated the impact of SGLT‐2 inhibitors on NAFLD . All included studies noted a significant improvement in AST and ALT.…”

Section: Treatment Optionsmentioning

confidence: 99%

Evolution of NAFLD and Its Management

et al. 2019

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The global prevalence of nonalcoholic fatty liver disease (NAFLD) is estimated to be 25% and continues to rise worldwide in the setting of the obesity epidemic. This increase is especially concerning because NAFLD is often a progressive disease that can be associated with significant complications such as liver cirrhosis, hepatocellular carcinoma, and an increase in liver-related and overall mortality. Because of the devastating complications and comorbidities, NAFLD is a very costly disease for the healthcare system, with estimated annual direct medical costs exceeding $100 billion in the United States alone. Given this progressive course, it is imperative to make the diagnosis in patients with risk factors (metabolic syndrome, weight gain, and insulin resistance/diabetes). Once the diagnosis is made, the focus should shift to treatment and monitoring for the development of associated complications. Given that currently no pharmaceutical intervention is approved for the treatment of NAFLD, focus shifts instead to mitigation of risk factors through avoidance of foods that are rich in red meat, trans fats, refined carbohydrates, and high-fructose corn syrup; are low fiber; and have high energy density. The landmark of treatment, however, continues to be weight loss and improvement of insulin resistance, often through a multimodality approach. The current manuscript reviews the clinical phenotypes of NAFLD, its risk factors, and pathogenesis, as well as treatment options including lifestyle modifications and dietary interventions, medical therapies, endoscopic bariatric interventions, and bariatric surgery. (Nutr Clin Pract. 2020;35:72-84) Keywords fatty liver; insulin resistance; liver cirrhosis; non-alcoholic fatty liver disease; nutrition therapy; weight loss From the

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SGLT-2 inhibitors in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus: A systematic review

Cited by 71 publications

References 39 publications

NAFLD as a continuum: from obesity to metabolic syndrome and diabetes

NAFLD as a continuum: from obesity to metabolic syndrome and diabetes

Recent advances in non-invasive diagnosis and medical management of non-alcoholic fatty liver disease in adult

Evolution of NAFLD and Its Management

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