Effects of dapagliflozin in type 2 diabetes patients with fatty liver

Aim: This study aimed to investigate the influences of a novel class of oral antidiabetic agent, sodium-glucose cotransporter 2 (SGLT2) inhibitor, on type 2 diabetes mellitus (T2DM) associated with fatty liver in the clinical setting. Methods: This was a retrospective, single-center, open-label, observational study conducted among Japanese outpatients with T2DM, who were newly treated with the SGLT2 inhibitor dapagliflozin in our hospital. Fatty liver was determined using an abdominal ultrasonography or computed tomography. Changes in HbA1c, blood glucose, BMI, liver function parameters, liver stiffness, and steatosis evaluated by transient elastography during the 12-month study period were assessed. Results: A total of 117 patients with T2DM were enrolled in the study: 33 of them concomitantly had fatty liver. Male patients accounted for 57.6%, and mean age was 56.8 years in the patients with fatty liver. The mean HbA1c was 7.61% at baseline and significantly (p<0.01) reduced by -0.50% (-6.6% reduction) 12 months after treatment. The BMI and liver function parameters, such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT), were also significantly reduced after the treatment (p<0.01). Transient elastography using FibroScan , which measures liver stiffness or steatosis, indicated that there was no obvious change after treatment: however, changes in these parameters were observed in one patient and were associated with changes in HbA1c and liver function parameters in this patient. Conclusion: In clinical setting, dapagliflozin improved HbA1c, reducing BMI and improving liver function parameters such as AST and ALT in Japanese T2DM patients with fatty liver.