Effect of Sodium Glucose Cotransporter 2 Inhibitors on Renal Function in Patients with Nonalcoholic Fatty Liver Disease and Type 2 Diabetes in Japan.

Kota Yano,Takeshi Okanoue,Keiichiroh Okuda,Hiroyoshi Taketani,Taichiro Nishikawa,Yoshito Itoh,Kanji Yamaguchi,Naoki Mizuno,Aya Takahashi,Seita Kataoka,Masashi Takemura,Michihisa Moriguchi,Atsushi Umemura,Shinya Okishio,Yuya Seko

doi:10.3390/diagnostics10020086

Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT2I) have been reported to have renal-protective effects in patients with type 2 diabetes (T2DM). This a retrospective study aimed to evaluate the effect of SGLT2I on renal function in patients with nonalcoholic fatty liver disease (NAFLD) and T2DM. We analyzed 69 consecutive patients with a biopsy-proven NAFLD and T2DM with an estimated glomerular filtration rate (eGFR) >60 mL/min. Of these 69 patients, 22 received SGLT2I and 47 were treated without SGLT2I. Liver function and eGFR were analyzed at baseline and after three years. Body mass index, liver function and HbA1c improved significantly in both groups. In the total population, the median eGFR declined from 80.7 mL/min at the baseline to 74.9 mL/min at the end of follow-up. The median eGFR at the baseline/end of follow-up was 81.2/80.4 mL/min in patients treated with SGLT2I and 80.2/70.8 mL/min in patients treated without SGLT2I. Multivariate analysis identified an increased FIB-4 index with an odds ratio (OR) of 4.721, (p = 0.045) and SGLT2I treatment (OR 0.263, p = 0.033) as predictive factors for decreased eGFR. SGLT2I treatment has a protective effect on the renal function for NAFLD with T2DM. A long-term, randomized, controlled trial is warranted to confirm the renal protective effect of SGLT2I in NAFLD patients with T2DM.

Highlights

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in Japan, and it affects up to 25–30% of the general adult population worldwide [1]
This study aims to clarify the association between liver function and renal function in the follow-up period and the impact of Sodium-glucose cotransporter-2 inhibitors (SGLT2I) treatment on renal function in nonalcoholic fatty liver disease (NAFLD) patients with type 2 diabetes mellitus (T2DM)
We investigated the effect of SGLT2I on renal function in patients with

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in Japan, and it affects up to 25–30% of the general adult population worldwide [1]. NAFLD is known to be associated with extrahepatic diseases, such as type 2 diabetes mellitus (T2DM), cardiovascular (CV) disease and chronic kidney disease (CKD) [2,3,4]. The association between NAFLD and CKD has attracted considerable attention, and many studies support the concept that NAFLD affects the incidence of CKD [5,6]. Patients with NAFLD have a high risk of incident CKD, which is considered to be associated with the severity of the NAFLD. Among patients with NAFLD, the presence of T2DM increases the risk of the development of CKD [7,8]. There are no established pharmacotherapies for NAFLD in patients with

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