PMID- 37845152
OWN - NLM
STAT- MEDLINE
DCOM- 20240325
LR  - 20240325
IS  - 1878-3562 (Electronic)
IS  - 1590-8658 (Linking)
VI  - 56
IP  - 4
DP  - 2024 Apr
TI  - Evolution of liver fibrosis in diabetic patients with NAFLD in a follow-up study: 
      Hepatoprotective effects of sodium-glucose co-transporter-2 inhibitors.
PG  - 551-558
LID - S1590-8658(23)00983-0 [pii]
LID - 10.1016/j.dld.2023.09.023 [doi]
AB  - BACKGROUND AND AIMS: Patients with non-alcoholic fatty liver disease (NAFLD) and 
      type 2 diabetes mellitus (T2DM) are at high risk of hepatic fibrosis. To 
      prospectively evaluate changes in fibrosis in diabetic patients with NAFLD, 
      predisposing factors and sodium glucose cotransporter 2 inhibitors (SGLT2i) 
      influence. METHODS: 237 T2DM outpatients (mean age 67 +/- 9 years, 54% male) were 
      enrolled and re-evaluated after 52 +/- 10 months. At baseline and follow-up NAFLD 
      and liver fibrosis (LSM) were detected by ultrasonography and Fibroscan(R). 
      RESULTS: During follow-up an increase in LSM (6.0 +/- 2.8 vs 5.8 +/- 2.7 kPa, p = 
      0.02) and in the prescription of SGLT2i (20% vs 6%, p<0.001) was registered, 
      despite stability of diabetic control. LSM worsened in 133(56%) subjects, 92 
      (39%) with worsening >10% from baseline. Patients with worsening versus non 
      worsening of LSM had higher prevalence of increase in BMI during follow-up (45% 
      vs 32%, p = 0.06) and lower SGLT2i prescription (15% vs 27%, p = 0.034). In 
      multivariate analysis use of SGLT2-inhibitors at follow-up reduced the risk of 
      LSM worsening (HR 0.34, 95% CI 0.13-0.88), even when considered>10% from 
      baseline. CONCLUSIONS: A high prevalence of fibrosis progression was observed in 
      diabetic subjects with NAFLD over a nearly 5-years follow up and SGLT2-inhibitors 
      seem to reduce the risk of worsening of liver stiffness.
CI  - Copyright (c) 2023 Editrice Gastroenterologica Italiana S.r.l. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Lombardi, Rosa
AU  - Lombardi R
AD  - SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore 
      Policlinico di Milano, Milan, Italy; Department of Pathophysiology and 
      Transplantation, University of Milan, Milan, Italy. Electronic address: 
      rosa.lombardi@unimi.it.
FAU - Mantovani, Alessandro
AU  - Mantovani A
AD  - Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, 
      University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, 
      Italy.
FAU - Cespiati, Annalisa
AU  - Cespiati A
AD  - SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore 
      Policlinico di Milano, Milan, Italy; Department of Pathophysiology and 
      Transplantation, University of Milan, Milan, Italy.
FAU - Francione, Paolo
AU  - Francione P
AD  - UO di Medicina, Azienda Ospedaliera "Card. G. Panico" di Tricase, Italy.
FAU - Maffi, Gabriele
AU  - Maffi G
AD  - SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore 
      Policlinico di Milano, Milan, Italy; Department of Pathophysiology and 
      Transplantation, University of Milan, Milan, Italy.
FAU - Del Zanna, Elena
AU  - Del Zanna E
AD  - SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore 
      Policlinico di Milano, Milan, Italy; Department of Pathophysiology and 
      Transplantation, University of Milan, Milan, Italy.
FAU - Maffeis, Claudio
AU  - Maffeis C
AD  - Pediatric Diabetes and Metabolic Disorders Unit, Department of Surgical Sciences, 
      Dentistry, and Pediatrics, and Gynaecology, University Hospital of Verona, 
      Verona, Italy.
FAU - Colecchia, Antonio
AU  - Colecchia A
AD  - Gastroenterology Unit, Department of Medical Specialities, University Hospital of 
      Modena, University of Modena & Reggio Emilia, Modena, Italy.
FAU - Passigato, Nicola
AU  - Passigato N
AD  - Gastroenterology Unit, University and Azienda Ospedaliera Universitaria Integrata 
      of Verona, Verona, Italy.
FAU - Ferrarese, Alberto
AU  - Ferrarese A
AD  - Gastroenterology Unit, University and Azienda Ospedaliera Universitaria Integrata 
      of Verona, Verona, Italy.
FAU - Cusumanu, Caterina Daniela
AU  - Cusumanu CD
AD  - Gastroenterology Unit, University and Azienda Ospedaliera Universitaria Integrata 
      of Verona, Verona, Italy.
FAU - Villani, Rosanna
AU  - Villani R
AD  - Centro C.U.R.E, Dept. of Medical and Surgical Sciences, University of Foggia, 
      Italy.
FAU - Orsi, Emanuela
AU  - Orsi E
AD  - Department of Medical Science, Endocrinology and Diabetes Unit, Ca' Granda IRCCS 
      Foundation, Policlinico Hospital, University of Milan Italy.
FAU - Grancini, Valeria
AU  - Grancini V
AD  - Department of Medical Science, Endocrinology and Diabetes Unit, Ca' Granda IRCCS 
      Foundation, Policlinico Hospital, University of Milan Italy.
FAU - Airaghi, Lorena
AU  - Airaghi L
AD  - SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore 
      Policlinico di Milano, Milan, Italy.
FAU - Bignamini, Daniela
AU  - Bignamini D
AD  - SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore 
      Policlinico di Milano, Milan, Italy.
FAU - Serviddio, Gaetano
AU  - Serviddio G
AD  - Centro C.U.R.E, Dept. of Medical and Surgical Sciences, University of Foggia, 
      Italy.
FAU - Targher, Giovanni
AU  - Targher G
AD  - Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases 
      Research Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, 
      Italy.
FAU - Dongiovanni, Paola
AU  - Dongiovanni P
AD  - SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore 
      Policlinico di Milano, Milan, Italy.
FAU - Fargion, Silvia
AU  - Fargion S
AD  - Department of Pathophysiology and Transplantation, University of Milan, Milan, 
      Italy.
FAU - Fracanzani, Anna Ludovica
AU  - Fracanzani AL
AD  - SC- Medicina-Indirizzo Metabolico, Fondazione IRCCS Ca' Granda Ospedale Maggiore 
      Policlinico di Milano, Milan, Italy; Department of Pathophysiology and 
      Transplantation, University of Milan, Milan, Italy.
LA  - eng
PT  - Journal Article
DEP - 20231014
PL  - Netherlands
TA  - Dig Liver Dis
JT  - Digestive and liver disease : official journal of the Italian Society of 
      Gastroenterology and the Italian Association for the Study of the Liver
JID - 100958385
RN  - 0 (Sodium-Glucose Transporter 2 Inhibitors)
RN  - 0 (Sodium-Glucose Transporter 2)
RN  - IY9XDZ35W2 (Glucose)
RN  - 9NEZ333N27 (Sodium)
SB  - IM
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Aged
MH  - Female
MH  - *Non-alcoholic Fatty Liver Disease/complications/drug therapy/epidemiology
MH  - Follow-Up Studies
MH  - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use
MH  - Liver/pathology
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy/epidemiology
MH  - Sodium-Glucose Transporter 2
MH  - Liver Cirrhosis/epidemiology
MH  - Fibrosis
MH  - *Elasticity Imaging Techniques
MH  - Glucose
MH  - Sodium
OTO - NOTNLM
OT  - Fibroscan
OT  - Follow-up study
OT  - Hepatic steatosis
OT  - Liver stiffness measurement
OT  - Nonalcoholic fatty liver disease
OT  - Prospective
OT  - SGLT2 inhibitors
OT  - Type 2 diabetes
COIS- Declaration of Competing Interest None declared.
EDAT- 2023/10/17 00:42
MHDA- 2024/03/25 06:43
CRDT- 2023/10/16 22:01
PHST- 2023/06/23 00:00 [received]
PHST- 2023/08/29 00:00 [revised]
PHST- 2023/09/27 00:00 [accepted]
PHST- 2024/03/25 06:43 [medline]
PHST- 2023/10/17 00:42 [pubmed]
PHST- 2023/10/16 22:01 [entrez]
AID - S1590-8658(23)00983-0 [pii]
AID - 10.1016/j.dld.2023.09.023 [doi]
PST - ppublish
SO  - Dig Liver Dis. 2024 Apr;56(4):551-558. doi: 10.1016/j.dld.2023.09.023. Epub 2023 
      Oct 14.