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首页> 外文期刊>Endocrinology, Diabetes & Metabolism >Noninvasive monitoring of liver fat during treatment with GLP‐1 analogues and SGLT‐2 inhibitors in a real‐world setting
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Noninvasive monitoring of liver fat during treatment with GLP‐1 analogues and SGLT‐2 inhibitors in a real‐world setting

机译：在真实世界环境中使用GLP-1类似物和SGLT-2抑制剂治疗期间肝脏脂肪的非侵袭监测

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Introduction Patients with NAFLD have a two‐fold increased risk of diabetes, and conversely, NAFLD affects up to 80% of patients with type 2 diabetes. Due to the co‐occurrence of both diseases and the lack of approved pharmacotherapy for NAFLD, the anti‐steatogenic potential of diabetes‐related drugs is being explored. In this study, we aim to monitor liver fat noninvasively during treatment with SGLT‐2 inhibitors or GLP‐1 analogues in a real‐world setting. Methods Overall, 39 patients (49% women, age 57.7?±?10.9?years) with type 2 diabetes and hepatic steatosis (defined by controlled attenuation parameter [CAP] values ≥?215?dB/m) were observed for 6?months and routinely monitored with respect to hepatic fat contents and liver stiffness (VCTE); body composition (BIA); and blood biochemistry, including liver function tests (LFTs), serum lipids and glucose metabolism markers. Results Median liver fat contents were significantly ( P =?.026) reduced by 9% in patients taking either SGLT‐2 (n?=?22) or GLP‐1 (n?=?17) for 6?months (absolute median CAP decrease: ?32?dB/m [?58 to 32?dB/m]). In parallel, serum ALT and γ‐GT activities decreased significantly ( P =?.002 and P =?.049, respectively). These improvements were accompanied by significant ( P ?.0001) changes to body weight and BMI (?2.5?±?3.3?kg and ?0.9?±?1.2?kg/msup2/sup, respectively) and glucose homeostasis, with significant reductions in HbAsub1c/sub and fasting plasma glucose (FDG) (both P ?.0001). Of note, significant reductions of intrahepatic lipid contents occured in patients receiving SGLT‐2 inhibitors only. Conclusions In this real‐world observational evaluation of fatty liver monitored noninvasively in patients with type 2 diabetes treated with either SGLT2 or GLP‐1, improvements in measures of hepatic steatosis, glucose and weight parameters were observed after 6?months, with significant reductions of intrahepatic lipid contents seen specifically in the SGLT2 subgroup.
机译：引言NAFLD患者患糖尿病的风险增加了两倍，而且相反，NAFLD影响了2型糖尿病患者的80％。由于疾病的共同发生和缺乏批准的NAFLD药物疗法，正在探讨糖尿病相关药物的抗脂肪源性潜力。在这项研究中，我们的目的是在用真实世界中的SGLT-2抑制剂或GLP-1类似物的治疗过程中非血液监测肝脏脂肪。方法总体而言，39名患者（49％妇女，57.7岁？±10.9岁），患有2型糖尿病和肝脏脂肪变性（由受控衰减参数[Cap]值≥≤215≤DB/ m）6？个月并常规监测肝脂肪含量和肝硬化（VCTE）;身体成分（BIA）;和血液化学，包括肝功能试验（LFT），血清脂质和葡萄糖代谢标志物。结果中位肝脂肪含量显着（p = 026），服用SGLT-2（n？=Δ22）或GLP-1（n？= 32），减少9％的患者6？月（绝对中位数帽减小：？32？db / m [α58至32≤db/ m]）。平行，血清ALT和γ-GT活性显着降低（P = 002和P = 049）。这些改进伴随着显着的（P <·0001）变化对体重和BMI（？2.5？±3.3？kg和？0.9？±1.2？kg / m 2 ）和葡萄糖稳态，具有显着减少HBA 1c 和禁食血浆葡萄糖（FDG）（P <0001）。值得注意的是，仅在接受SGLT-2抑制剂的患者中发生肝内脂质含量的显着降低。结论在这种现实世界观测性评价脂肪肝的脂肪肝监测的2型糖尿病患者中，患有SGLT2或GLP-1治疗的2型糖尿病，在6〜30后观察到肝脏脂肪变性，葡萄糖和重量参数的措施的改善，显着降低特别是在SGLT2亚组中特别看到的肝内脂质含量。

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