PMID- 38346734
OWN - NLM
STAT- Publisher
LR  - 20240212
IS  - 1349-7235 (Electronic)
IS  - 0918-2918 (Linking)
DP  - 2024 Feb 12
TI  - Clinical Efficacy and Body Composition Changes with Sodium Glucose Cotransporter 
      2 Inhibitor/Glucagon-like Peptide-1 Antagonist Combination Therapy in Patients 
      with Type 2 Diabetes Mellitus-associated Nonalcoholic Fatty Liver Disease.
LID - 10.2169/internalmedicine.3259-23 [doi]
AB  - Objective Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis 
      (NAFLD/NASH) treatment guidelines recommend sodium glucose cotransporter 2 
      inhibitor (SGLT2I) and glucagon-like peptide-1 agonist (GLP-1A) therapy in 
      patients with type 2 diabetes mellitus (T2DM). SGLT2I improves the pathological 
      condition of NAFLD/NASH in T2DM patients. However, cases of rebound during 
      long-term SGLT2I treatment have been reported. This study investigated the 
      efficacy of SGLT2I and GLP-1A combination therapy in diabetic patients with NAFLD 
      by examining changes in computed tomography (CT)-based body composition and 
      clinical outcomes. Methods Fifteen patients (5 men/10 women) with T2DM-associated 
      NAFLD who had not responded to SGLT2I treatment and were being treated with 
      GLP-1A combination therapy were included. Changes in the liver function, visceral 
      adipose tissue index (VATI), and subcutaneous adipose tissue index (SATI) were 
      compared using CT to evaluate the body composition. Results SGLT2I significantly 
      improved alanine aminotransferase (28.0 to 13.0 IU/L), alkaline phosphatase 
      (250.0 to 77.0 IU/L), and gamma glutamyl transpeptidase (23.0 to 12.0 IU/L) 
      levels. The body mass index (BMI) decreased from 25.7 to 25.2 kg/m(2). A CT-based 
      analysis showed a significant improvement in SATI (80.9 to 66.1, p=0.002), with 
      no significant change in VATI (53.2 to 51.5). GLP-1A addition improved the BMI 
      (25.2 to 23.5 kg/m(2)) and hemoglobin A1c (6.5% to 6.2%, p=0.001). A further 
      analysis revealed additional improvement in SATI (66.1 to 56.6, p=0.007) and a 
      significant decrease in VATI (51.5 to 48.3, p=0.001). Conclusion SGLT2I and 
      GLP-1A combination therapy improved the liver function, body composition, and 
      glycemic control in diabetic patients with NAFLD/NASH, as well as SATI and VATI. 
      The optimal timing of combination therapy remains to be determined.
FAU - Ishikawa, Toru
AU  - Ishikawa T
AD  - Department of Gastroenterology, Saiseikai Niigata Hospital, Japan.
FAU - Terai, Nanako
AU  - Terai N
AD  - Department of Radiographer, Saiseikai Niigata Hospital, Japan.
FAU - Sato, Ryo
AU  - Sato R
AD  - Department of Gastroenterology, Saiseikai Niigata Hospital, Japan.
FAU - Jimbo, Ryo
AU  - Jimbo R
AD  - Department of Gastroenterology, Saiseikai Niigata Hospital, Japan.
FAU - Kobayashi, Yuji
AU  - Kobayashi Y
AD  - Department of Gastroenterology, Saiseikai Niigata Hospital, Japan.
FAU - Sato, Toshifumi
AU  - Sato T
AD  - Department of Gastroenterology, Saiseikai Niigata Hospital, Japan.
FAU - Iwanaga, Akito
AU  - Iwanaga A
AD  - Department of Gastroenterology, Saiseikai Niigata Hospital, Japan.
FAU - Sano, Tomoe
AU  - Sano T
AD  - Department of Gastroenterology, Saiseikai Niigata Hospital, Japan.
FAU - Yokoyama, Junji
AU  - Yokoyama J
AD  - Department of Gastroenterology, Saiseikai Niigata Hospital, Japan.
FAU - Honma, Terasu
AU  - Honma T
AD  - Department of Gastroenterology, Saiseikai Niigata Hospital, Japan.
LA  - eng
PT  - Journal Article
DEP - 20240212
PL  - Japan
TA  - Intern Med
JT  - Internal medicine (Tokyo, Japan)
JID - 9204241
SB  - IM
OTO - NOTNLM
OT  - body composition
OT  - glucagon-like peptide 1 receptor agonists
OT  - liver function
OT  - nonalcoholic fatty liver disease
OT  - sodium-glucose transporter-2 inhibitors
OT  - type 2 diabetes mellitus
EDAT- 2024/02/13 00:42
MHDA- 2024/02/13 00:42
CRDT- 2024/02/12 20:33
PHST- 2024/02/13 00:42 [medline]
PHST- 2024/02/13 00:42 [pubmed]
PHST- 2024/02/12 20:33 [entrez]
AID - 10.2169/internalmedicine.3259-23 [doi]
PST - aheadofprint
SO  - Intern Med. 2024 Feb 12. doi: 10.2169/internalmedicine.3259-23.