Gao Xiuying, Zhu Chuanming, Zhu Wei, Wang Lin
Department of Endocrinology, Beijing Aerospace General Hospital, Beijing 100076, P.R. China.
Department of Radiology, Beijing Aerospace General Hospital, Beijing 100076, P.R. China.
Biomed Rep. 2024 Dec 5;22(2):26. doi: 10.3892/br.2024.1904. eCollection 2025 Feb.
Non-alcoholic fatty liver disease (NAFLD) is common in patients with type 2 diabetes mellitus (T2DM). The present study evaluated the effect of dapagliflozin on the liver fat content in patients with T2DM and NAFLD. The changes in biochemical data and metabolic parameters were analyzed. Clinical data of patients with T2DM and NAFLD treated by dapagliflozin were retrospectively collected between June 2022 and December 2022. A total of 35 patients, with a mean age of 45.8±2.2 years, consisting of 60.0% male patients, were included in the final analysis. After 20 weeks of dapagliflozin treatment, the parameters of diabetes improved. Plasma glucose and hemoglobin A1 levels significantly decreased (P<0.01), and insulin resistance improved. The change in liver fat content was evaluated by quantitative computed tomography, which revealed a decrease from 16.1±2.2 to 11.2±1.3% after treatment (P<0.01). Liver function (alanine aminotransferase, aspartate aminotransferase and γ-glutamyltransferase levels) also improved. Visceral and subcutaneous fat areas showed a significant decrease after treatment, and there was a more significant reduction in visceral fat area. The factors associated with liver fat content were determined by Pearson's correlation and regression analyses. Pearson's correlation analysis indicated that the post-treatment decrease in liver fat content was positively correlated with the change in body weight (r=0.642, P=0.033), index of homeostasis model assessment-insulin resistance (r=0.670, P=0.048), triglycerides (r=0.627, P=0.039), high sensitivity C-reactive protein (r=0.608, P=0.047) and interleukin (IL)-6 (r=0.604, P=0.049). Linear regression analysis revealed that body weight (β=0.416, P=0.001), IL-6 (β=0.284, P=0.009), triglycerides (β=0.262, P=0.011) and total cholesterol (β=0.388, P=0.001) were independent factors related to liver fat content. In conclusion, dapagliflozin can reduce liver fat in patients with T2DM and NAFLD. The reduction in liver fat is associated with improvement of metabolic parameters and inflammatory cytokines.
非酒精性脂肪性肝病（NAFLD）在2型糖尿病（T2DM）患者中很常见。本研究评估了达格列净对T2DM合并NAFLD患者肝脏脂肪含量的影响。分析了生化数据和代谢参数的变化。回顾性收集了2022年6月至2022年12月期间接受达格列净治疗的T2DM合并NAFLD患者的临床资料。最终分析纳入了35例患者，平均年龄为45.8±2.2岁，男性患者占60.0%。达格列净治疗20周后，糖尿病参数得到改善。血糖和糖化血红蛋白A1水平显著降低（P<0.01），胰岛素抵抗得到改善。通过定量计算机断层扫描评估肝脏脂肪含量的变化，结果显示治疗后肝脏脂肪含量从16.1±2.2%降至11.2±1.3%（P<0.01）。肝功能（丙氨酸氨基转移酶、天冬氨酸氨基转移酶和γ-谷氨酰转移酶水平）也有所改善。治疗后内脏和皮下脂肪面积显著减小，且内脏脂肪面积减小更为明显。通过Pearson相关性分析和回归分析确定与肝脏脂肪含量相关的因素。Pearson相关性分析表明，治疗后肝脏脂肪含量的降低与体重变化（r=0.642，P=0.033）、稳态模型评估-胰岛素抵抗指数（r=0.670，P=0.048）、甘油三酯（r=0.627，P=0.039）、高敏C反应蛋白（r=0.608，P=0.047）和白细胞介素（IL）-6（r=0.604，P=0.049）呈正相关。线性回归分析显示，体重（β=0.416，P=0.001）、IL-6（β=0.284，P=0.009）、甘油三酯（β=0.262，P=0.011）和总胆固醇（β=0.388，P=0.001）是与肝脏脂肪含量相关的独立因素。总之，达格列净可降低T2DM合并NAFLD患者的肝脏脂肪。肝脏脂肪的减少与代谢参数和炎性细胞因子的改善有关。
