Ipragliflozin Ameliorates Liver Damage in Non-alcoholic Fatty Liver Disease.

Teruki Miyake,Shin Yamamoto,Abe Masanori,Teru Kumagi,Masashi Hirooka,Bunzo Matsuura,Hiroaki Miyaoka,Tetsuju Niiya,Shinya Furukawa,Takenori Sakai,Osamu Yoshida,Yoichi Hiasa,Hidenori Senba,Sakiko Yoshida,Yohei Koizumi,Fujimasa Tada

doi:10.1515/med-2018-0059

Abstract

BackgroundThere are few effective medications for non-alcoholic steatohepatitis (NASH). We investigated the efficacy of ipragliflozin (selective sodium-glucose cotransporter-2 inhibitor [SGLT2I]) for the treatment of patients with type 2 diabetes mellitus (T2DM) complicated by non-alcoholic fatty liver disease (NAFLD).MethodsWe prospectively enrolled patients with T2DM complicated by NAFLD treated at our institutions from January 2015 to December 2016. Patients received oral ipragliflozin (50 mg/day) once daily for 24 weeks. Body composition was evaluated using an InBody720 analyzer. We used transient elastography to measure liver stiffness and the controlled attenuation parameter for the quantification of liver steatosis in patients with NASH.ResultsForty-three patients with T2DM and NAFLD were enrolled (12 with biopsy-proven NASH and 31 with NAFLD diagnosed by ultrasonography). After 24 weeks, body weight, hemoglobin A1c (HbA1c), aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase, body fat mass, and steatosis were significantly decreased compared to baseline measurements in patients with NASH. However, muscle mass was not reduced, and liver stiffness showed a statistically insignificant tendency to decrease. NAFLD patients also showed a significant reduction in body weight, HbA1c, AST, and ALT compared to baseline measurements. ConclusionIpragliflozin may be effective in patients with T2DM complicated by NAFLD.

Highlights

In modern times, obesity and a lack of exercise have increased the incidence of non-alcoholic fatty liver disease (NAFLD) [1, 2]
20 patients with biopsy-proven non-alcoholic steatohepatitis (NASH) and 40 with NAFLD diagnosed by ultrasonography presented to our diabetes clinics and were included for analysis in our study
The administration of ipragliflozin for 24 weeks significantly decreased body weight, hemoglobin A1c (HbA1c), AST, and ALT compared to baseline measurements in the 31 patients with NAFLD (p < 0.05; Table 5)

Summary

Introduction

Obesity and a lack of exercise have increased the incidence of non-alcoholic fatty liver disease (NAFLD) [1, 2]. Several studies evaluated methods for diagnosing NAFLD and demonstrated the usefulness of ultrasonography and magnetic resonance imaging for the measurement of hepatic fibrosis, fat deposition, and splanchnic blood flow including that in the liver [6,7,8,9,10,11]. These techniques help clinicians to identify patients with NASH, they are not widely used. We investigated the efficacy of ipragliflozin (selective sodium-glucose cotransporter-2 inhibitor [SGLT2I]) for the treatment of patients with type 2 diabetes mellitus (T2DM) complicated by non-alcoholic fatty liver disease (NAFLD)

Methods

Results

Conclusion