scholarly journals Effect of ipragliflozin on metabolic syndrome components and non-alcoholic fatty liver disease

2021 ◽  
pp. 305-310
Author(s):  
N. A. Petunina ◽  
M. E. Telnova ◽  
I. A. Kuzina

Sodium-glucose cotransporter-2 inhibitors are the new drugs for the treatment of type 2 diabetes mellitus. Its mechanism of action is to increase the excretion of glucose in the urine due to inhibition of reabsorption in the proximal renal tubules, which leads to a decrease in blood glucose levels. These drugs also have pleiotropic effects including reduce body weight and blood pressure, improve the lipid profile (raising high-density lipoprotein cholesterol and lowering triglyceride levels), and reduce the risk of cardiovascular death and nephroprotection. Ipragliflozin, a new representative of the class of sodium glucose cotransporter-2 inhibitors, registered in Russia, has shown effectiveness in relation to glycemic control, reducing the levels of glycated hemoglobin and fasting plasma glucose both in monotherapy and in combination with other antihyperglycemic drugs. The PRIME-V and ILLUMINATE studies have demonstrated that ipragliflozin helps to reduce insulin resistance, body weight, BMI and waist circumference, total and LDL cholesterol. Positive effects of ipragliflozin on pancreatic β-cell mass and function have been shown in animal studies. Several studies have examined the beneficial effects of ipragliflozin on the course of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus. Significant reductions in ALT and GGT levels and a decrease in the absolute percentage of liver fat have been shown. Animal studies have confirmed the effect of ipragliflozin on the histological characteristics of NASH. The review presents data on the efficacy of ipragliflozin in relation to the components of the metabolic syndrome in patients with type 2 diabetes mellitus, and also discusses the likely mechanisms of a positive effect of the drug on the course of NASH in type 2 diabetes mellitus. 

2021 ◽  
Vol 12 ◽  
pp. 204201882110002
Author(s):  
Taeang Arai ◽  
Masanori Atsukawa ◽  
Akihito Tsubota ◽  
Shigeru Mikami ◽  
Hiroki Ono ◽  
...  

Background: Although sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) improve not only glycemic control but also liver inflammation and fatty changes in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM), its sustainability and effect on liver fibrosis have remained unclear. The current study aimed to clarify the effects of 48-week SGLT2-I therapy on liver inflammation, fatty changes, and fibrosis in NAFLD patients with T2DM. Methods: This study evaluated the effects of SGLT2-I on NAFLD, including liver fibrosis assessed via transient elastography, in 56 patients with NAFLD who received SGLT2-I for 48 weeks. Moreover, changes in each clinical parameter between patients receiving SGLT2-I (the SGLT2-I group) and those receiving other oral hypoglycemic agents (OHAs) (the non-SGLT2-I group) were compared, using 1:1 propensity score matching to adjust for baseline factors. Results: The SGLT2-I group exhibited a significant decrease in controlled attenuation parameter (312 dB/m at baseline to 280 dB/m at week 48) and liver stiffness measurement (9.1–6.7 kPa) ( p < 0.001 for both). After propensity score matching (44 patients each in the SGLT2-I and non-SGLT2-I groups), no significant difference in HbA1c decrease was observed between the two groups. However, compared with the non-SGLT2-I group, the SGLT2-I group showed a significant decrease in body weight ( p < 0.001), alanine aminotransferase ( p = 0.02), uric acid ( p < 0.001), and Fibrosis-4 (FIB-4) index ( p = 0.01) at week 48. The improvement in FIB-4 index, defined as a ⩾10% decline from baseline at week 48, was 56.8% (25/44) in the SGLT2-I group and 20.5% (9/44) in the non-SGLT2-I group ( p < 0.001). Conclusion: SGLT2-Is improved not only glycemic control but also liver fatty infiltration and fibrosis in patients with NAFLD and T2DM, suggesting their possible superiority to other OHAs concerning these effects.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A11-A12
Author(s):  
Ehizogie Edigin ◽  
Precious Eseaton ◽  
Hafeez Shaka ◽  
Emmanuel Akuna ◽  
Iriagbonse Asemota ◽  
...  

Abstract Introduction: Psoriasis is a chronic immune-mediated, genetic disease manifesting in the skin or joints or both. Studies have shown an association between psoriasis and metabolic syndrome [1]. However, there is a scarcity of studies on metabolic and endocrine co-morbidities of hospitalized psoriasis patients. This study aims to compare the prevalence of metabolic and endocrine co-morbidities in hospitalized psoriasis patients to hospitalized non-psoriasis patients. Methods: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. NIS is the largest inpatient hospitalization database in the United States. The NIS was searched for hospitalizations for adult patients aged 18 years or above with a principal or secondary diagnosis of psoriasis and those without any diagnosis of psoriasis. Chi-square test was used to compare the prevalence of common metabolic and endocrine comorbidities between psoriasis and non-psoriasis hospitalized patients. Co-morbidities were obtained from secondary diagnoses. We used ICD-10 codes to obtain psoriasis hospitalizations and co-morbidities. STATA, version 16 was used for analysis. Results: There were over 71 million discharges in the combined 2016 and 2017 NIS database. Out of this, 323,405 hospitalizations had a diagnosis of psoriasis. Psoriasis hospitalizations had a higher prevalence of dyslipidemia (41.8% vs 31.8%, p&lt;0.0001), hypothyroidism (15.6% vs 12.0%, p&lt;0.0001), hyperthyroidism (0.6% vs 0.5%, p=0.0133), type 2 diabetes mellitus (31.1% vs 24.5%, p&lt;0.0001), obesity (24.4% vs 14.3%, p&lt;0.0001), Non-alcoholic fatty liver disease (0.9% vs 0.3%, p&lt;0.0001) and similar prevalence of type 1 diabetes mellitus (0.9% vs 0.9%, p=0.1567) compared to non-psoriasis hospitalizations. Conclusion: Hospitalized psoriasis patients have a higher prevalence of dyslipidemia, hypothyroidism, hyperthyroidism, type 2 diabetes mellitus, obesity and non-alcoholic fatty liver disease compared to non-psoriasis hospitalized patients. Endocrinology consultation during hospitalization will be helpful in managing these comorbidities in psoriasis patients. References 1. Gisondi P, Fostini AC, Fossà I, Girolomoni G, Targher G. Psoriasis and the metabolic syndrome. Clin Dermatol. 2018;36(1):21–28. doi:10.1016/j.clindermatol.2017.09.005


Author(s):  
Abdullah Alsabaani ◽  
Ahmed Mahfouz ◽  
Nabil Awadalla ◽  
Mustafa Musa ◽  
Suliman Al Humayed

The objective of this study was to determine the prevalence and the factors associated with non-alcoholic fatty liver disease (NAFLD) among type-2 diabetes mellitus (T2DM) patients in Abha City, Southwestern Saudi Arabia. Using a cross-sectional study design, a representative sample of 245 T2DM patients were recruited from all primary healthcare centers in Abha city. A detailed medical history as well as laboratory investigations were done. NAFLD was diagnosed using abdominal ultrasound examination. The overall prevalence of NAFLD was 72.8% (95% CI: 66.6%–78.1%). In a multivariable regression analysis, the risk of NAFLD was significantly higher among overweight T2DM patients (aOR = 6.112, 95% CI: 1.529–4.432), Obese (aOR = 10.455, 95% CI: 2.645–41.326), with high ALT of more than 12 IU/L (aOR = 2.335, 95% CI: 1.096–5.062), moderate diet-compliant patients (aOR = 2.413, 95% CI: 1.003–5.805) and poor diet-compliant patients (aOR = 6.562, 95% CI: 2.056–20.967). On the other hand, high HDL (high density cholesterol) (in mg/dL) was a protective factor for NAFLD (aOR = 0.044, 95% CI: 0.005–0.365). It was concluded that NAFLD is a common association of T2DM. Increasing BMI (Body mass index), lower HDL level, and poor dietary control are significant factors associated with NAFLD among T2DM patients. Health education to improve dietary control and avoid excessive weight gain, testing for NAFLD among diabetic patients, especially those with abnormal BMI and HDL, are recommended for early detection and to ensure optimal levels of HDL.


2018 ◽  
Vol 38 (6) ◽  
Author(s):  
Feng Tian ◽  
Zhigang Zheng ◽  
Damin Zhang ◽  
Si He ◽  
Jie Shen

Type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD) is difficult to treat. The present study explored the efficacy of (liraglutide) Lira in treating T2DM complicated with NAFLD. A total of 127 patients suffering from T2DM complicated with NAFLD were enrolled in the present study, and randomly assigned to a Lira group (liraglutide injection: 0.6–1.2 mg/day, 12 weeks, n=52) or a Metformin (Met) group (oral metformin: 1000–1500 mg/day, 12 weeks, n=75). During the treatment phase, the values for fasting plasma glucose (FPG), 2 h plasma glucose (2hPG), glycated hemoglobin (HbA1c), aspartate aminotransferase (AST)/alanine aminotransferase (ALT), and adiponectin (APN) decreased in both the Lira and Met groups, and the levels of Δ2hPG, ΔAST/ALT, and ΔAPN in the Lira group were significantly lower than those in the Met group. The values for total cholesterol (TC), triglycerides (TG), low-and high-density lipoproteins (LDL and HDL), ALT, AST, weight, body mass index (BMI), waist to hip ratio (WHR), and C-reactive protein were markedly increased in both groups, and levels of ΔAST, ΔALT, Δweight, ΔBMI, ΔWHR, and ΔCRP (C-reactive protein) in the Lira group were significantly higher than those in the Met group. An analysis of treatment efficacy showed that liraglutide was better than metformin in its ability to significantly decrease the ALT levels in patients with combined T2DM and NAFLD. Furthermore, liraglutide was more effective than metformin at ameliorating the severity of T2DM complicated with NAFLD, and produced its effects by alleviating liver inflammation and improving liver function.


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