Liu Hua, Hao Yang-Min, Jiang Sheng, Baihetiyaer Maiheliya, Li Cheng, Sang Guo-Yao, Li Zhiming, Du Guo-Li
State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia, Urumqi, Xinjiang, People's Republic of China.
Department of Endocrinology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.
Int J Gen Med. 2024 Jun 5;17:2613-2625. doi: 10.2147/IJGM.S460200. eCollection 2024.
This study aims to investigate the relationship between Sodium Glucose Co-transporter-2 inhibitors (SGLT2i) treatment and fibrosis in patients with Metabolic dysfunction-associated steatotic liver disease (MASLD) combined with Type 2 Diabetes Mellitus (T2DM) and Major Adverse Cardiovascular and Cerebrovascular Events (MACCEs).
A case-control study was conducted, involving 280 patients with MASLD combined with T2DM treated at the First Affiliated Hospital of Xinjiang Medical University from January 2014 to October 2023. Among these patients, 135 received SGLT2i treatment. The association between the Fibrosis-4 (FIB-4) index and the occurrence of MACCEs, as well as the association between the Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) scores and MACCEs, were evaluated.
The FIB-4 index and APRI scores were significantly lower in the SGLT2i treatment group compared to the non-SGLT2i group (1.59 vs 1.25, <0.001). SGLT2i treatment tended to reduce the occurrence of MACCEs compared to non-SGLT2i treatment (45.5% vs 38.5%, =0.28). All patients who developed MACCEs in the non-SGLT2i treatment group had higher FIB-4 index (1.83 vs 1.35, =0.003). Additionally, after SGLT2i treatment for a median duration of 22 months, patients showed significant reductions in blood glucose, APRI, and FIB-4 index.
SGLT2i treatment significantly reduces the occurrence of MACCEs and liver fibrosis in patients with MASLD combined with T2DM. The FIB-4 index may serve as a potential surrogate marker for predicting the occurrence of MACCEs.
本研究旨在探讨钠-葡萄糖协同转运蛋白2抑制剂（SGLT2i）治疗与代谢功能障碍相关脂肪性肝病（MASLD）合并2型糖尿病（T2DM）患者的纤维化以及主要不良心血管和脑血管事件（MACCEs）之间的关系。
进行了一项病例对照研究，纳入2014年1月至2023年10月在新疆医科大学第一附属医院接受治疗的280例MASLD合并T2DM患者。其中，135例接受SGLT2i治疗。评估了纤维化-4（FIB-4）指数与MACCEs发生之间的关联，以及天冬氨酸转氨酶与血小板比值指数（APRI）评分与MACCEs之间的关联。
与非SGLT2i组相比，SGLT2i治疗组的FIB-4指数和APRI评分显著更低（1.59对1.25，<0.001）。与非SGLT2i治疗相比，SGLT2i治疗倾向于降低MACCEs的发生（45.5%对38.5%，=0.28）。非SGLT2i治疗组中所有发生MACCEs的患者FIB-4指数更高（1.83对1.35，=0.003）。此外，在SGLT2i治疗中位持续时间22个月后，患者的血糖、APRI和FIB-4指数显著降低。
SGLT2i治疗可显著降低MASLD合并T2DM患者MACCEs的发生和肝纤维化。FIB-4指数可能作为预测MACCEs发生的潜在替代标志物。
