Lower prevalence of elevated liver stiffness measurements in people with type 2 diabetes taking sodium-glucose co-transporter 2 inhibitors or glucagon-like peptide-1 receptor agonists

Lucy Gracen; Withma Muthukumara; Melanie Aikebuse; Anthony Russell; James O'Beirne; Katharine M Irvine; Suzanne Williams; Gaurav Puri; Patricia C Valery; Kelly L Hayward; Elizabeth E Powell

doi:10.1016/j.aohep.2023.101142

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Lower prevalence of elevated liver stiffness measurements in people with type 2 diabetes taking sodium-glucose co-transporter 2 inhibitors or glucagon-like peptide-1 receptor agonists

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Lower prevalence of elevated liver stiffness measurements in people with type 2 diabetes taking sodium-glucose co-transporter 2 inhibitors or glucagon-like peptide-1 receptor agonists

Lucy Gracen, Withma Muthukumara, Melanie Aikebuse, Anthony Russell, James O'Beirne, Katharine M Irvine, Suzanne Williams, Gaurav Puri, Patricia C Valery, Kelly L Hayward, …

Annals of Hepatology, Vol.28, pp.1-6

2023

DOI: https://doi.org/10.1016/j.aohep.2023.101142

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Abstract

Non-alcoholic fatty liver diseas

Diabetes mellitus, type 2

Sodium-glucose transporter 2 inhibitors

Hypoglycemic Agents

Glucagon-Like Peptide-1 Receptor

Elasticity Imaging Techniques

Introduction and Objectives: Among people with type 2 diabetes (T2D), non-alcoholic fatty liver disease (NAFLD) is very common and has an increased risk of clinically significant liver disease. The use of sodium-glucose co-transporter 2 (SGLT2i) inhibitors and glucagon-like peptide-1 (GLP-1a) receptor agonists is endorsed to reduce major cardiovascular events and/or progression of chronic kidney disease. Their prevalence of use in people with T2D and co-existent NAFLD remains unclear. We sought to determine the prevalence of use of these medications at two different time periods, and their association with prevalence of clinically significant liver disease. Materials and Methods: Consecutive people with type 2 diabetes (T2D) and non-alcoholic fatty liver disease (NAFLD) were recruited from diabetes clinics between Jun-2021 and Jun-2022 ('current' cohort). Liver stiffness measurements (LSM) using FibroScan were performed. Medication data were collected prospectively at recruitment and verified with the dispensing pharmacy or general practitioner medical records. Data for a historical cohort with NAFLD and T2D recruited from the same clinics during 2015−2017 ('historical' cohort) were available. Logistic regression was used to evaluate factors associated with LSM <8.0 or ≥8 kPa (clinically significant fibrosis). Results: There were 292 participants, 177 in the historical cohort and 115 in the current cohort. In the current cohort, 57.4% of patients with T2D and NAFLD were taking a GLP-1a and 42.6% were taking a SGLT2i; a 2.6 to 3.4-fold higher prevalence than in 2015−2017. A lower proportion of the current cohort (23.9% compared to 38.4%) had clinically significant fibrosis (LSM ≥8 kPa; p = 0.012). When the cohorts were pooled and differences adjusted for in multivariable logistic regression analysis, patients taking a GLP-1a or a SGLT2i were 2 times more likely to have a lower LSM (<8 kPa) compared to patients not taking these drugs (OR=2.05, 95%CI 1.07 −3.94, p = 0.03 and OR 2.07 95%CI 1.04−4.11, p = 0.04, respectively). Conclusions: The observation of a lower LSM in people taking SGLT2i and/or GLP-1a following adjustment for other relevant clinico-demographic variables provides support for clinical trials to assess their efficacy in reducing the progression of NAFLD. Crown

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Title: Lower prevalence of elevated liver stiffness measurements in people with type 2 diabetes taking sodium-glucose co-transporter 2 inhibitors or glucagon-like peptide-1 receptor agonists
Authors: Lucy Gracen (Author) - Translational Research Institute
Withma Muthukumara (Author) - Translational Research Institute
Melanie Aikebuse (Author) - Translational Research Institute
Anthony Russell (Author) - The University of Queensland
James O'Beirne (Author) - Sunshine Coast University Hospital
Katharine M Irvine (Author) - Translational Research Institute
Suzanne Williams (Author) - Inala Community Health Centre
Gaurav Puri (Author) - Logan Hospital
Patricia C Valery (Author) - QIMR Berghofer Medical Research Institute
Kelly L Hayward (Author) - Translational Research Institute
Elizabeth E Powell (Corresponding Author) - Translational Research Institute
Publication details: Annals of Hepatology, Vol.28, pp.1-6
Publisher: Asociacion Mexicana de Hepatologia
Date published: 2023
DOI: 10.1016/j.aohep.2023.101142
ISSN: 2659-5982; 1665-2681
Copyright note: © 2023 Published by Elsevier España, S.L.U. on behalf of Fundación Clínica Médica Sur, A.C. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Organisation Unit: University of the Sunshine Coast, Queensland; School of Health and Behavioural Sciences - Legacy
Language: English
Record Identifier: 99741790302621
Output Type: Journal article

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