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达格列净对 2 型糖尿病合并非酒精性脂肪性肝病患者肝及胰腺脂肪的影响。

Effect of dapagliflozin on liver and pancreatic fat in patients with type 2 diabetes and non-alcoholic fatty liver disease.

机构信息

Department of Nutrition of Xinqiao Hospital, Army Medical University, Chongqing, China.

Department of Endocrinology of Xinqiao Hospital, Army Medical University, Chongqing, China.

出版信息

J Diabetes Complications. 2023 Oct;37(10):108610. doi: 10.1016/j.jdiacomp.2023.108610. Epub 2023 Sep 1.

Abstract

AIMS

To evaluate the effect of dapagliflozin on liver fat content (LFC) and pancreatic fat content (PFC).

MATERIALS AND METHODS

84 patients with type 2 diabetes (T2D) and non-alcoholic fatty liver disease (NAFLD) were randomly assigned to receive either dapagliflozin (n = 42) or serve as controls (n = 42). The primary endpoint is changes in LFC and PFC using magnetic resonance imaging estimated proton density fat fraction. Secondary outcomes include liver fibrosis index, inflammatory cytokine levels, and liver enzyme levels.

RESULTS

At week 24, the dapagliflozin group significantly reduced LFC (P < 0.001) and PFC (P = 0.033) compared to the control group. Differences were also observed in serum levels of tumor necrosis factor-α (TNF-α) (P = 0.004), interleukin-6 (IL-6) (P = 0.001), and alanine aminotransferase (ALT) (P < 0.001) between the two groups.

CONCLUSIONS

Dapagliflozin can significantly decrease LFC and PFC in patients with T2D and NAFLD. It also improves serum ALT, TNF-α, and IL-6 levels, making it a promising treatment option for NAFLD. The trial is registered on Chinese Clinical Trial Registry (Registration No. ChiCTR2100054612).

摘要

目的

评估达格列净对肝脂肪含量(LFC)和胰腺脂肪含量(PFC)的影响。

材料和方法

84 例 2 型糖尿病(T2D)合并非酒精性脂肪性肝病(NAFLD)患者被随机分为达格列净组(n=42)或对照组(n=42)。主要终点是使用磁共振成像估计质子密度脂肪分数评估 LFC 和 PFC 的变化。次要结局包括肝纤维化指数、炎症细胞因子水平和肝酶水平。

结果

在 24 周时,与对照组相比,达格列净组显著降低了 LFC(P<0.001)和 PFC(P=0.033)。两组间肿瘤坏死因子-α(TNF-α)(P=0.004)、白细胞介素-6(IL-6)(P=0.001)和丙氨酸氨基转移酶(ALT)(P<0.001)的血清水平也存在差异。

结论

达格列净可显著降低 T2D 和 NAFLD 患者的 LFC 和 PFC。它还改善了血清 ALT、TNF-α 和 IL-6 水平,是治疗 NAFLD 的一种有前途的方法。该试验在中国临床试验注册中心(注册号 ChiCTR2100054612)注册。

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