Abstract
IntroductionNonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, with a global prevalence of 20%-40%. Approximately 40%-60% of patients with type 2 diabetes mellitus (DM2) experience NAFLD; out of which 20%-40% cases may have higher severity. Due to the scarcity of available reports from the eastern part of India, we aimed to evaluate the effects of dapagliflozin, a sodium-glucose cotransporter-2 inhibitor used in these types of cases.Material and methodsThe study included consecutive patients with DM2 and NAFLD, treated with dapagliflozin at 10 mg daily for six months. All patients underwent detailed anthropometric, biochemical, abdominal ultrasonography, and transient elastography studies at baseline and after therapy as well as a comparative analysis.ResultsIn the 100 patients included in our study, the male patients outnumbered the female patients (male-to-female ratio, 4.27:-1) and the mean age at presentation was 44.11 ± 8.24 years. The mean body mass index significantly decreased over the course of the therapy, from 27.31± 1.87 kg/m2 at baseline to 26.21 ± 1.51 kg/m2 after the therapy. The patients’ transaminitis, dyslipidemia, and glycemic status significantly improved over the course of the therapy. We also observed significant (p < 0.05) improvement in hepatic steatosis by the end of the treatment. Although transient elastography by FibroScan-measured hepatic fibrosis score (Echosens, Paris, France) significantly decreased from 6.95 ± 1.42 to 6 ± 1.44 kPa, hepatic fibrosis did not improve significantly (p ≥ 0.05) following therapy.ConclusionAlthough dapagliflozin improved body mass index, transaminitis, dyslipidemia, glycemic status, and hepatic steatosis, it had a minimal effect on hepatic fibrosis.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, with a global prevalence of 20%-40%
By subjecting the patients to appropriate investigations, NAFLD was diagnosed on the basis of ultrasound evidence of hepatic steatosis, after ruling out other causative factors of hepatic steatosis, such as significant alcohol consumption, negative hepatitis B and C viral serology, autoimmune hepatitis, hepatic storage disorders, such as hemochromatosis and Wilson’s disease, the consumption of suspicious drugs, and other diseases that might be associated with hepatic steatosis
We found significant improvement in various liver enzyme biochemical parameters after dapagliflozin therapy, as reported in previous studies [17,18,19,20,21]
Summary
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, with a global prevalence of 20%-40%. 40%-60% of patients with type 2 diabetes mellitus (DM2) experience NAFLD; out of which 20%-40% cases may have higher severity. Due to the scarcity of available reports from the eastern part of India, we aimed to evaluate the effects of dapagliflozin, a sodium-glucose cotransporter-2 inhibitor used in these types of cases. Review began 04/25/2021 Review ended 05/05/2021 Published 05/11/2021
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