Introduction & Objective: Diabetes and the liver are related. Obesity may affect the progression of metabolic dysfunction-associated steatotic liver disease (MASLD)/metabolic associated steatohepatitis (MASH). The effects of sodium-glucose transport protein 2 inhibitors (SGLT2is) on hepatic steatosis and liver fibrosis were examined in a subanalysis of a study that evaluated visceral fat area reduction related to ipragliflozin (SGLT2i) or metformin.
Methods: Overall, 103 Japanese patients with type 2 diabetes, a body mass index of >22 kg/m2, and 7-10% glycated hemoglobin level were randomized to receive ipragliflozin 50 mg or metformin 1000 mg for 24 weeks. As hepatic steatosis indices, fatty liver index (FLI), hepatic steatosis index (HSI), and NAFLD-liver fat score (LFS) and as liver fibrosis indexes, AST to platelet ratio index (APRI) and fibrosis-4 (FIB-4) were compared between the groups.
Results: At baseline, intergroup differences in background characteristics or any index were insignificant. As the table shows, after 24 weeks, FLI, HSI, LFS, and APRI significantly improved in the ipragliflozin group.
Conclusion: Compared with metformin, ipragliflozin significantly improved multiple hepatic steatosis and liver fibrosis indexes, suggesting that ipragliflozin may alleviate hepatic steatosis, prevent liver fibrosis progression, and improve glycemic control. Therefore, it may prevent MASLD/MASH.
M. Koshizaka: None. K. Hirayama: None. R. Ishibashi: Research Support; Astellas Pharma Inc., Taiho Pharmaceutical Co. Ltd. K. Sakurai: None. K. Yokote: Research Support; Taisho Pharmaceutical Holdings Co., Ltd., Mitsubishi Tanabe Pharma Corporation, Boehringer-Ingelheim, Sumitomo Dainippon Pharma Co., Ltd., Kowa Company, Ltd. Speaker's Bureau; Kowa Company, Ltd., Sumitomo Dainippon Pharma Co., Ltd., Novo Nordisk, Novartis Pharmaceuticals Corporation, Daiichi Sankyo.
