scholarly journals Ipragliflozin Additively Ameliorates Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Controlled with Metformin and Pioglitazone: A 24-Week Randomized Controlled Trial

2020 ◽  
Vol 9 (1) ◽  
pp. 259 ◽  
Author(s):  
Eugene Han ◽  
Yong-ho Lee ◽  
Byung-Wan Lee ◽  
Eun Seok Kang ◽  
Bong-Soo Cha
Keyword(s):  
Type 2 Diabetes ◽  
Fatty Liver ◽  
Visceral Fat ◽  
Controlled Trial ◽  
Subcutaneous Fat ◽  
Liver Fat ◽  
Whole Body ◽  
Alcoholic Fatty Liver ◽  
Fatty Liver Index

Despite the benefits of pioglitazone in the treatment of non-alcoholic fatty liver disease (NAFLD), many treated patients continue to experience disease progression. We aimed to investigate the additive effect of ipragliflozin on NAFLD in patients with type 2 diabetes treated with metformin and pioglitazone. In this 24-week randomized controlled trial, 44 patients with type 2 diabetes and comorbid NAFLD were either randomized to receive 50 mg/day of ipragliflozin as an add-on treatment (n = 29) or maintained on metformin and pioglitazone (n = 15). The fatty burden was assessed using the fatty liver index, NAFLD liver fat score, and controlled attenuation parameter (CAP). Changes in fat and muscle depots were measured by dual-energy x-ray absorptiometry and abdominal computed tomography scans. The enrolled patients were relatively controlled (mean baseline glycated hemoglobin of 6.6% ± 0.6%) and centrally obese (mean waist circumference of 101.6 ± 10.9 cm). At week 24, patients in the ipragliflozin add-on group exhibited reduced hepatic fat content (fatty liver index: −9.8 ± 1.9, p = 0.002; NAFLD liver fat score: −0.5 ± 0.2, p = 0.049; CAP: −8.2 ± 7.8 dB/m2, p = 0.133). Ipragliflozin add-on therapy also reduced whole-body visceral fat and the ratio of visceral to subcutaneous fat (change in whole-body visceral fat: −69.6 ± 21.5 g; change in abdominal visceral fat: −26.2 ± 3.7 cm2; abdominal visceral to subcutaneous fat ratio: −0.15 ± 0.04; all p < 0.05). In conclusion, ipragliflozin treatment significantly ameliorates liver steatosis and reduces excessive fat in euglycemic patients with type 2 diabetes and NAFLD taking metformin and pioglitazone.

Dapagliflozin reduces hepatic and visceral fat in type‐2 diabetes patients with non‐alcoholic fatty liver disease

2021 ◽  
Author(s):  
Susrichit Phrueksotsai ◽  
Kanokwan Pinyopornpanish ◽  
Juntima Euathrongchit ◽  
Apinya Leerapun ◽  
Arintaya Phrommintikul ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Visceral Fat ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease ◽  
Diabetes Patients

scholarly journals Effect of Short Term Intensive Lifestyle Intervention on Hepatic Steatosis Indexes in Adults with Obesity and/or Type 2 Diabetes

2019 ◽  
Vol 8 (6) ◽  
pp. 851 ◽  
Author(s):  
Elisa Reginato ◽  
Roberto Pippi ◽  
Cristina Aiello ◽  
Emilia Sbroma Tomaro ◽  
Claudia Ranucci ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Lifestyle Intervention ◽  
Intervention Program ◽  
Liver Fat ◽  
Alcoholic Fatty Liver ◽  
Lifestyle Intervention Program ◽  
Alcoholic Fatty Liver Disease

Background: Non-alcoholic fatty liver disease (NAFLD) has an estimated prevalence of 20–30% in the general population and even higher in individuals with metabolic risk factors. The aim of this study was to evaluate the effect of a lifestyle intervention program on surrogate markers of hepatic steatosis in obesity and/or type 2 diabetes patients, enrolled in the C.U.R.I.A.Mo. (Centro Universitario di Ricerca Interdipartimentale Attività Motoria) trial. Methods: 102 subjects (56 females and 46 males, aged between 23 and 78) with type 2 diabetes, obesity or a BMI of at least 25 kg/m2 with comorbidities, participated in the intensive phase of a multidisciplinary lifestyle intervention program at the Healthy Lifestyle Institute of the University of Perugia (C.U.R.I.A.Mo.). Six indices related to NAFLD (Visceral Adiposity Index, Fatty Liver index, Non-Alcoholic Fatty Liver Disease liver fat score and liver fat equation, hepatic steatosis index and TyG index) were calculated before and after a three-month multidisciplinary lifestyle intervention. Results: The intervention improved the anthropometric and clinical parameters in the total population, the obese and/or diabetics. Data showed a significant weight loss, a reduced waist circumference, triglycerides, and an improvement in Mediterranean diet adherence. Hepatic steatosis indices were significantly reduced in the total population and in different subgroups (males, females, obesity and diabetes).

Efficacy of diacerein in reducing liver steatosis and fibrosis in patients with type 2 diabetes and non‐alcoholic fatty liver disease: A randomized, placebo‐controlled trial

2019 ◽  
Vol 21 (5) ◽  
pp. 1266-1270 ◽  
Author(s):  
Nathalie C. Leite ◽  
Bianca B. Viegas ◽  
Cristiane A. Villela‐Nogueira ◽  
Fernanda O. Carlos ◽  
Claudia R.L. Cardoso ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Controlled Trial ◽  
Liver Steatosis ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Exercise without weight loss is an effective strategy for obesity reduction in obese individuals with and without Type 2 diabetes

2005 ◽  
Vol 99 (3) ◽  
pp. 1220-1225 ◽  
Author(s):  
SoJung Lee ◽  
Jennifer L. Kuk ◽  
Lance E. Davidson ◽  
Robert Hudson ◽  
Katherine Kilpatrick ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Weight Loss ◽  
Visceral Fat ◽  
Subcutaneous Fat ◽  
Substantial Reduction ◽  
Whole Body ◽  
Moderate Intensity ◽  
Regional Body Composition

It is unclear whether chronic exercise without caloric restriction or weight loss is a useful strategy for obesity reduction in obese men with and without Type 2 diabetes (T2D). We examined the effects of exercise without weight loss on total and regional adiposity and skeletal muscle mass and composition in lean men and in obese men with and without T2D. Twenty-four men participated in 13 wk of supervised aerobic exercise, five times per week for 60 min at a moderate intensity (∼60% peak oxygen uptake). Total and regional body composition was measured by magnetic resonance imaging. Skeletal muscle composition was determined using computed tomography. Cardiorespiratory fitness was assessed using a graded maximal treadmill test. Body weight did not change within any group in response to exercise ( P > 0.1). Significant reductions in total, abdominal subcutaneous, and visceral fat were observed within each group ( P < 0.01). The reduction in total and abdominal subcutaneous fat was not different ( P > 0.1) between groups; however, the reduction in visceral fat was greater ( P < 0.01) in the obese and T2D groups by comparison to the lean group. A significant ( P < 0.01) increase in total skeletal muscle, high-density muscle area, and mean muscle attenuation was observed independent of group, and these changes were not different between groups ( P > 0.1). Accordingly, whole body fat-to-muscle ratio was increased ( P < 0.01) independent of groups. In conclusion, regular exercise without weight loss is associated with a substantial reduction in total and visceral fat and in skeletal muscle lipid in both obesity and T2D.

scholarly journals Fatty liver index and progression to type 2 diabetes: a 5-year longitudinal study in Spanish workers with pre-diabetes

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045498
Author(s):  
Carla Busquets-Cortés ◽  
Miquel Bennasar-Veny ◽  
Angel-Arturo López-González ◽  
Sergio Fresneda ◽  
Antoni Aguiló ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Fatty Liver ◽  
Hepatic Steatosis ◽  
Occupational Health Services ◽  
Alcoholic Fatty Liver ◽  
Liver Index ◽  
Fatty Liver Index

ObjectiveThe main aim of the study was to evaluate the association between non-alcoholic fatty liver disease (NAFLD), estimated by fatty liver index (FLI), and the development of type 2 diabetes (T2D) in a large cohort of adult workers with pre-diabetes.DesignProspective cohort study.SettingOccupational health services from Spain.Participants16 648 adult workers (aged 20–65 years) with pre-diabetes (fasting plasma glucose (FPG) of 100–125 mg/dL).Outcome and measuresFLI was calculated based on measurements of triglycerides, body mass index, waist circumference and γ-glutamyltransferase. The population was classified into three categories: FLI<30 (no hepatic steatosis), FLI 30–60 (intermediate status) and FLI>60 (hepatic steatosis). Sociodemographic, anthropometric, dietary habits, physical activity and clinical data were collected from all subjects. The incidence rate of T2D was determined after 5 years of follow-up.ResultsAfter 5 years of follow-up, 3706 of the 16 648 participants (22.2%) were diagnosed with T2D, corresponding to an annual rate of progression of 4.5%. FLI was strongly associated with T2D conversion. The incidence rates of T2D in the FLI<30, FLI 30–60 and FLI>60 groups were significantly different after 5 years of follow-up were 19/6,421 (0.3%), 338/4,318 (7.8%) and 3,349/5,909 (56.7%), respectively. This association remained significant for FLI>60 after adjustment for, age, diet, physical activity, FPG, blood pressure, social class and smoking habits (adjusted HR=6.879; 95% CI 5.873 to 8.057 for men, and HR=5.806; 95% CI 4.863 to 6.932 for women).ConclusionNAFLD assessed by FLI independently predicted the risk of conversion to T2D among people with pre-diabetes. FLI may be an easily determined and valuable early predictor for T2D in people with pre-diabetes. FLI-based assessment of NAFLD in subjects with pre-diabetes in routine clinical practice could allow the adoption of effective measures to prevent and reduce their progression to T2D.

Circulating Glycerolipids, Fatty Liver Index and Incidence of Type 2 Diabetes: A Prospective Study among Chinese

2021 ◽  
Author(s):  
Zhenhua Niu ◽  
QingQing Wu ◽  
Liang Sun ◽  
Qibin Qi ◽  
He Zheng ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Fatty Liver ◽  
Liver Fat ◽  
Fat Accumulation ◽  
Mediation Analyses ◽  
Liver Index ◽  
Asian Populations ◽  
Relative Risks ◽  
Fatty Liver Index

Abstract Context Few lipidomic studies have specifically investigated the association of circulating glycerolipids and type 2 diabetes (T2D) risk, especially among Asian populations. It remains unknown whether or to what degree fatty liver could explain the glycerolipids-T2D associations. Objective We aimed to assess associations between plasma glycerolipids and incident T2D, and explore a potential role of liver fat accumulation in the associations. Design A prospective cohort study with 6-year of follow-up. Participants This work included 1,781 Chinese aged 50-70 years. Main Outcome Measures T2D. Results At 6-year resurvey, 463 participants developed T2D. At the false-discovery rate (FDR) of 5%, 43 of 104 glycerolipids were significantly associated with incident T2D risk after multivariate adjustment for conventional risk factors. After further controlling for glycated hemoglobin (HbA1c), 9 of the 43 glycerolipids remained significant, including 2 diacylglycerols (DAGs)(16:1/20:4, 18:2/20:5) and 7 triacylglycerols (TAGs)(46:1, 48:0, 48:1, 50:0, 50:1, 50:2, and 52:2), with relative risks (RRs) (95% confidence intervals [CIs]) ranging from 1.16 (1.05 to 1.27) to 1.23 (1.11 to 1.36) per SD increment of glycerolipids. However, additional adjustment for fatty liver index (FLI) largely attenuated these findings (RRs [95% CIs] were 0.88 [0.81 to 0.95] to 1.10 [1.01 to 1.21]). Mediation analyses suggested that the FLI explained 12%-28% glycerolipids-T2D associations (all p &lt; 0.01). Conclusions Higher plasma levels of DAGs and TAGs were associated with increased incident T2D risk in this Chinese population, which might be partially explained by liver fat accumulation.

scholarly journals The amount of liver fat predicts mortality and development of type 2 diabetes in non‐alcoholic fatty liver disease

2020 ◽  
Vol 40 (5) ◽  
pp. 1069-1078 ◽  
Author(s):  
Patrik Nasr ◽  
Mats Fredrikson ◽  
Mattias Ekstedt ◽  
Stergios Kechagias
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Fat ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

scholarly journals Efficacy of Sodium-Glucose Cotransporter 2 Inhibitors in Patients With Concurrent Type 2 Diabetes Mellitus and Non-Alcoholic Steatohepatitis: A Review of the Evidence

2021 ◽  
Vol 12 ◽  
Author(s):  
Koichi Yabiku
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Structural Changes ◽  
Experimental Studies ◽  
Liver Fat ◽  
Renal Diseases ◽  
Alcoholic Fatty Liver ◽  
Antidiabetic Treatment

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease worldwide, and more than half of individuals diagnosed with type 2 diabetes concurrently present with NAFLD. There is a bidirectional pathological relationship between the two conditions, whereby NAFLD increases the risk of type 2 diabetes, and type 2 diabetes contributes to and accelerates the progression of NAFLD. Furthermore, over 30% of patients with NAFLD progress to non-alcoholic liver steatohepatitis (NASH), which then increases the risk of cirrhosis and hepatocellular carcinoma. Despite its high prevalence and the potential clinical implications, the underlying pathogenesis of NAFLD has yet to be fully elucidated, and there is no consensus regarding standard diagnosis and treatment for either NALFD or NASH. As patients with both NASH and type 2 diabetes have impaired hepatic function owing to chronic inflammation and the resulting structural changes caused by hepatic fat accumulation, they face reduced options for antidiabetic treatment. SGLT-2 inhibitors inhibit glucose reabsorption in the proximal tubule, with increased excretion of glucose in urine and decreased glucose levels in plasma, and their glycemia-lowering effect is insulin-independent. Several other beneficial effects have been reported for SGLT-2 inhibitors, including reduced risks of cardiovascular and renal diseases, improved blood pressure control, body weight reduction, and reductions in liver fat content. Experimental studies in mouse models have suggested that SGLT-2 inhibitors may have beneficial modulatory effects on NAFLD/NASH. Several trials in patients with type 2 diabetes have also suggested that these drugs may be useful in treating both type 2 diabetes and NAFLD or NASH. However, further research is needed to identify the mechanisms by which SGLT-2 inhibitors affect fatty liver and steatohepatitis. In this state-of-the-art review, we explore the literature on the efficacy of SGLT-2 inhibitors in patients with type 2 diabetes and NASH, and present arguments for and against the use of SGLT-2 inhibitors in this patient population.

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