Tobita Hiroshi, Yazaki Tomotaka, Kataoka Masatoshi, Kotani Satoshi, Oka Akihiko, Mishiro Tsuyoshi, Oshima Naoki, Kawashima Kousaku, Ishimura Norihisa, Naora Kohji, Sato Shuichi, Ishihara Shunji
Division of Hepatology, Shimane University Hospital, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan.
Department of Internal Medicine II, Shimane University School of Medicine, 89-1 Enya-cho, Izumo, Shimane 693-8501, Japan.
J Clin Biochem Nutr. 2021 Mar;68(2):173-180. doi: 10.3164/jcbn.20-129. Epub 2020 Dec 26.
There are no reports regarding the efficacy of sodium-glucose cotransporter 2 inhibitor (SGLT2i) and dipeptidyl peptidase 4 inhibitor (DPP4i) administrations in nonalcoholic fatty liver disease (NAFLD) patients without type 2 diabetes mellitus. The purpose of this study was to evaluate the efficacy of those drugs in such patients. NAFLD patients without type 2 diabetes mellitus were enrolled in this single center double-blind randomized prospective study, and allocated to receive either dapagliflozin (SGLT2i) or teneligliptin (DPP4i) for 12 weeks. Laboratory variables and body compositions were assessed at the baseline and end of treatment. The primary endpoint was alanine aminotransferase (ALT) reduction level at the end of treatment. Twenty-two eligible patients (dapagliflozin group, = 12; teneligliptin group, = 10) were analyzed. In both groups, the serum concentration of ALT was significantly decreased after treatment (<0.05). Multiple regression analysis results showed that decreased body weight of patients with dapagliflozin administration was significantly related to changes in total body water and body fat mass. Administration of dapagliflozin or teneligliptin decreased the serum concentration of ALT in NAFLD patients without type 2 diabetes mellitus. With dapagliflozin, body weight decreased, which was related to changes in total body water and body fat mass (UMIN000027304).
目前尚无关于在无2型糖尿病的非酒精性脂肪性肝病(NAFLD)患者中使用钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)和二肽基肽酶4抑制剂(DPP4i)疗效的报道。本研究的目的是评估这些药物在此类患者中的疗效。无2型糖尿病的NAFLD患者被纳入这项单中心双盲随机前瞻性研究,并被分配接受达格列净(SGLT2i)或替格列汀(DPP4i)治疗12周。在治疗基线和结束时评估实验室指标和身体成分。主要终点是治疗结束时丙氨酸氨基转移酶(ALT)的降低水平。对22例符合条件的患者(达格列净组,n = 12;替格列汀组,n = 10)进行了分析。两组治疗后ALT血清浓度均显著降低(P<0.05)。多元回归分析结果显示,使用达格列净的患者体重下降与总体水和体脂量的变化显著相关。在无2型糖尿病的NAFLD患者中,使用达格列净或替格列汀可降低ALT血清浓度。使用达格列净时,体重下降,这与总体水和体脂量的变化有关(UMIN000027304)。