The effect of SGLT2 inhibitors on hepatic steatosis detected by MRI-PDFF in patients with type 2 Diabetes mellitus and metabolic-associated steatotic liver disease.

IF 3.2 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Mona Ahmed Amin, Noha Adly Sadik, Hala Ahmed Saad, Mohammed Fawzy, Hend Abdallah Elsheimy
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Abstract

Sodium-glucose co-transporter type-2 (SGLT2) inhibitors have been identified to have a crucial hepatoprotective role in patients with type 2 diabetes (T2DM) and metabolic-associated steatotic liver disease (MASLD). Thus, we aimed to assess the effect of SGLT2 inhibitors on hepatic steatosis in patients with T2DM and MASLD added to the standard of care (SOC) treatment. Our study was a single-arm clinical trial with trial no ISRCTN85961860. Thirty T2DM patients with MASLD were recruited from the outpatient endocrinology and diabetes clinic of the Internal Medicine Department at Kasr Al-Aini Hospital, Cairo University, Egypt. Our Patients received Empagliflozin 10 mg daily which was added to SOC treatment and followed up for 24 weeks. Magnetic resonance imaging proton density fat fraction (MRI-PDFF) was done at baseline and after 24 weeks to assess the percentage change in hepatic fat mass. Also changes in Fib-4 and NAFLD fibrosis scores were calculated. Our study showed a statistically significant decrease in the mean MRI-PDFF measurement of hepatic steatosis after 24 weeks of adding empagliflozin to SOC treatment (13.297 ± 7.15) compared to the mean at baseline (15.288 ± 8.72), P = 0.006 with overall percentage decrease about 13.16% of liver steatosis. There were significant decreases in BMI, fasting blood glucose, and Alanine transaminase, (P < 0.001, 0.03, 0.01) respectively. There were no significant differences in Fib-4 or NAFLD fibrosis scores. Adding empagliflozin 10 mg to the standard treatment in patients with diabetes and MASLD could reduce hepatic fat mass significantly after 24 weeks of treatment. Thus, adding SGLT2 inhibitors to the clinical practice guidelines could be a therapeutic agent for patients with MASLD and T2DM.

MRI-PDFF检测SGLT2抑制剂对2型糖尿病合并代谢相关脂肪变性肝病患者肝脂肪变性的影响
钠-葡萄糖共转运蛋白2型(SGLT2)抑制剂已被确定在2型糖尿病(T2DM)和代谢相关脂肪变性肝病(MASLD)患者中具有重要的肝脏保护作用。因此,我们旨在评估SGLT2抑制剂对T2DM和MASLD患者肝脂肪变性的影响,这些患者加入了标准护理(SOC)治疗。我们的研究是单臂临床试验,试验号为ISRCTN85961860。从埃及开罗大学Kasr Al-Aini医院内科门诊内分泌科和糖尿病诊所招募了30例伴有MASLD的2型糖尿病患者。患者接受恩帕列净10mg /天的治疗,并在SOC治疗的基础上进行随访24周。在基线和24周后进行磁共振成像质子密度脂肪分数(MRI-PDFF)以评估肝脏脂肪块的百分比变化。同时计算Fib-4和NAFLD纤维化评分的变化。我们的研究显示,与基线时的平均值(15.288±8.72)相比,加入依格列净治疗24周后,肝脏脂肪变性的MRI-PDFF平均测量值(13.297±7.15)有统计学意义,P = 0.006,肝脏脂肪变性的总体百分比下降约13.16%。BMI、空腹血糖和丙氨酸转氨酶均显著降低(P
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来源期刊
Internal and Emergency Medicine
Internal and Emergency Medicine 医学-医学:内科
CiteScore
7.20
自引率
4.30%
发文量
258
审稿时长
6-12 weeks
期刊介绍: Internal and Emergency Medicine (IEM) is an independent, international, English-language, peer-reviewed journal designed for internists and emergency physicians. IEM publishes a variety of manuscript types including Original investigations, Review articles, Letters to the Editor, Editorials and Commentaries. Occasionally IEM accepts unsolicited Reviews, Commentaries or Editorials. The journal is divided into three sections, i.e., Internal Medicine, Emergency Medicine and Clinical Evidence and Health Technology Assessment, with three separate editorial boards. In the Internal Medicine section, invited Case records and Physical examinations, devoted to underlining the role of a clinical approach in selected clinical cases, are also published. The Emergency Medicine section will include a Morbidity and Mortality Report and an Airway Forum concerning the management of difficult airway problems. As far as Critical Care is becoming an integral part of Emergency Medicine, a new sub-section will report the literature that concerns the interface not only for the care of the critical patient in the Emergency Department, but also in the Intensive Care Unit. Finally, in the Clinical Evidence and Health Technology Assessment section brief discussions of topics of evidence-based medicine (Cochrane’s corner) and Research updates are published. IEM encourages letters of rebuttal and criticism of published articles. Topics of interest include all subjects that relate to the science and practice of Internal and Emergency Medicine.
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