Koh Yamashita1* and Toru Aizawa1
Received: March 15, 2021; Published: March 23, 2021
*Corresponding author: Koh Yamashita, Diabetes Center, Aizawa Hospital, 2-5-1 Honjo, Matsumoto, Japan
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Background: Non-alcoholic fatty liver disease is not simply the hepatic manifestation of obesity and diabetes but also linked to hepatocellular carcinoma. Yet, its effective treatment has not been established. In this study, we evaluated the effect of a short-term administration of luseogliflozin to patients with type 2 diabetes having non-alcohol fatty liver disease. Luseogliflozin is a unique sodium-glucose cotransporter 2 inhibitor which is metabolized in and excreted by the liver in addition to the kidney. Therefore, the drug might possess an additional effect on other agents of the same class which are exclusively metabolized in the kidney.
Methods: Using alanine aminotransferase >20 IU/L as a diagnostic basis for non-alcoholic fatty liver disease, 19 patients, not taking alcohol, with type 2 diabetes (male/female 15/4, the median age 57 years) was treated with 2.5 mg luseogliflozin for 12 weeks.
Results: Pre- and post-treatment median values for alanine aminotransferase were 51 IU/L and 33 IU/L (p = 0.001), and the corresponding values for the fibrosis index based on the four factors [age (years) ∙ alanine aminotransferase (IU/L)] / [platelets (109/L) ∙ alanine aminotransferase (IU/L)1/2)] were 1.669 and 1.314 (p = 0.043). There was no adverse effect of the drug. Our findings were essentially compatible with the results of the previous studies reviewed.
Conclusion: We conclude that sodium-glucose cotransporter 2 inhibitor could be the choice for the pharmacological treatment of non-alcoholic fatty liver disease. Especially, a short-term administration of it is consistently effective in mild cases.
Keywords: SGLT2 inhibitor; NAFLD; Fibrosis-4 index; GPR-index; APRI.
Abbreviations: SGLT2i: sodium-glucose cotransporter 2 inhibitor; NAFLD: non-alcoholic fatty liver disease; NASH: non-alcoholic steatohepatitis; T2DM: type 2 diabetes mellitus; AST: aspartate aminotransferase; ALT: alanine aminotransferase; GGT: gammaglutamyl transpeptidase; Fib-4 index: Fibrosis-4 index; GPR-index: gamma-glutamyl transpeptidase to platelet ratio; APRI: aspartate aminotransferase to platelet ratio
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