PMID- 32448832
OWN - NLM
STAT- MEDLINE
DCOM- 20201223
LR  - 20201223
IS  - 1349-7235 (Electronic)
IS  - 0918-2918 (Print)
IS  - 0918-2918 (Linking)
VI  - 59
IP  - 16
DP  - 2020 Aug 15
TI  - SGLT2 Inhibitor Treatment Outcome in Nonalcoholic Fatty Liver Disease Complicated 
      with Diabetes Mellitus: The Long-term Effects on Clinical Features and Liver 
      Histopathology.
PG  - 1931-1937
LID - 10.2169/internalmedicine.4398-19 [doi]
AB  - Objective The aim of this study was to determine the long-term effects of a 
      sodium-glucose cotransporter 2 inhibitor (SGLT2i) in nonalcoholic fatty liver 
      disease (NAFLD) patients with type 2 diabetes mellitus (T2DM) on the clinical 
      features and liver histopathology. Methods In this retrospective study, the 
      long-term histological impacts of SGLT2i in NAFLD patients with T2DM were 
      investigated. Patients Seven patients with NAFLD and T2DM were treated for the 
      long term with 100 mg/day canagliflozin, an SGLT2i, and liver biopsies were 
      obtained at the 3 points of pretreatment, 24 weeks, and >/=1 year (third liver 
      biopsy) after the start of treatment. Six of seven patients were evaluated with 
      third liver biopsy at the point of three or more years. The primary outcome was 
      liver histopathological changes (defined as a decrease in the NAFLD activity 
      score of one point or more without worsening of the fibrosis stage, compared to 
      pretreatment). Results All 7 patients showed worsening of body mass index and 
      waist circumference at the third liver biopsy compared to 24 weeks. However, the 
      scores of steatosis, lobular inflammation, ballooning, and fibrosis stage 
      improved at the third liver biopsy in 57%, 43%, 14%, and 29% of the patients, 
      respectively, compared to pretreatment. One of the seven patients showed 
      histopathological worsening at the third liver biopsy compared to pretreatment, 
      but the improvement was maintained in the other six patients. Conclusion The 
      long-term treatment of NAFLD complicated by T2DM using an SGLT2i is associated 
      with long-term improvement in liver histopathology despite the worsening of 
      clinical features.
FAU - Akuta, Norio
AU  - Akuta N
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Kawamura, Yusuke
AU  - Kawamura Y
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Fujiyama, Shunichiro
AU  - Fujiyama S
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Sezaki, Hitomi
AU  - Sezaki H
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Hosaka, Tetsuya
AU  - Hosaka T
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Kobayashi, Masahiro
AU  - Kobayashi M
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Kobayashi, Mariko
AU  - Kobayashi M
AD  - Liver Research Laboratory, Toranomon Hospital, Japan.
FAU - Saitoh, Satoshi
AU  - Saitoh S
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Suzuki, Fumitaka
AU  - Suzuki F
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Suzuki, Yoshiyuki
AU  - Suzuki Y
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Arase, Yasuji
AU  - Arase Y
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Ikeda, Kenji
AU  - Ikeda K
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
FAU - Kumada, Hiromitsu
AU  - Kumada H
AD  - Department of Hepatology, Toranomon Hospital and Okinaka Memorial Institute for 
      Medical Research, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200523
PL  - Japan
TA  - Intern Med
JT  - Internal medicine (Tokyo, Japan)
JID - 9204241
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
SB  - IM
MH  - Adult
MH  - Biopsy
MH  - Body Weights and Measures
MH  - Diabetes Mellitus, Type 2/*drug therapy/*epidemiology
MH  - Female
MH  - Humans
MH  - Japan/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Non-alcoholic Fatty Liver Disease/*epidemiology/*pathology
MH  - Retrospective Studies
MH  - Sodium-Glucose Transporter 2 Inhibitors/*therapeutic use
MH  - Treatment Outcome
PMC - PMC7492114
OTO - NOTNLM
OT  - SGLT2 inhibitor
OT  - diabetes mellitus
OT  - fibrosis stage
OT  - hepatocyte steatosis
OT  - liver biopsy
OT  - long-term
OT  - nonalcoholic fatty liver disease
OT  - nonalcoholic steatohepatitis
COIS- Author's disclosure of potential Conflicts of Interest (COI). Norio Akuta: 
      Honoraria, Mitsubishi Tanabe Pharma, AbbVie and Gilead Sciences. Masahiro 
      Kobayashi: Honoraria, Eisai. Yasuji Arase: Honoraria, AbbVie. Hiromitsu Kumada: 
      Honoraria, MSD, Gilead Sciences, AbbVie, Eisai and Dainippon Sumitomo Pharma.
EDAT- 2020/05/26 06:00
MHDA- 2020/12/29 06:00
PMCR- 2020/08/15
CRDT- 2020/05/26 06:00
PHST- 2020/05/26 06:00 [pubmed]
PHST- 2020/12/29 06:00 [medline]
PHST- 2020/05/26 06:00 [entrez]
PHST- 2020/08/15 00:00 [pmc-release]
AID - 10.2169/internalmedicine.4398-19 [doi]
PST - ppublish
SO  - Intern Med. 2020 Aug 15;59(16):1931-1937. doi: 10.2169/internalmedicine.4398-19. 
      Epub 2020 May 23.