Sumida Y1*, Yoneda M1, Tokushige K2, Kawanaka M3, Fujii H4, Yoneda M5, Imajo K5, Takahashi H6, Ono M7, Nozaki Y8, Hyogo H9, Koseki M10, Yoshida Y11, Kawaguchi T12, Kamada Y13, Eguchi Y14, Okanoue T15, Nakajima A5; Japan Study Group of NAFLD (JSG-NAFLD)16
1Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi Medical University, Japan
2Department of Internal Medicine, Institute of Gastroenterology, Tokyo Women’s Medical University, Tokyo, Japan
3Department of General Internal Medicine2, Kawasaki Medical School, Okayama 700-8505, Japan
4Department of Hepatology, Graduate School of Medicine, Osaka City University, Osaka, Japan
5Division of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
6Department of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan
7Division of Gastroenterology and Hepatology, Department of Internal Medicine,Tokyo Women’s Medical University Medical Center East, Tokyo, Japan
8Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan
9Department of Gastroenterology, JA Hiroshima General Hospital, Japan
10Department of Cardiovascular Medicine, Department of Medicine, Osaka University Graduate School of Medicine
11Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Osaka, Japan
12Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
13Department of Molecular Biochemistry & Clinical Investigation, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
14Liver Center, Saga University Hospital, Saga, Japan
15Hepatology Center, Saiseikai Suita Hospital, Osaka, Japan
16Japan Strategic Medical Administration Research Center, Nagoya, Aichi, Japan
Corresponding Author: Yoshio Sumida
Address: Division of Hepatology and Pancreatology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi 480-1195, Japan; Tel: +81-561-62-3311; Fax: +81-561-62-1508; Email: firstname.lastname@example.org
Received date: 04 February 2020; Accepted date: 26 February 2020; Published date: 05 March 2020
A fourth of the adult population is now suffering from nonalcoholic fatty liver disease (NAFLD) worldwide. Nonalcoholic steatohepatitis (NASH), a severe form of NAFLD, can lead to liver-related mortality. NAFLD/NASH is closely associated with type 2 diabetes. Although pioglitazone is now recommended as the 1st line therapy for NASH with type 2 diabetes, pioglitazone has several safety concerns such as body weight gain, heart failure, fluid retention, and bone fracture in women. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have a variety of functions such as glycemic control, bodyweight reduction, and decreased body pressure. Accumulating evidence has shown that this agent has also cardioprotective and renoprotective effects in patients with or without type 2 diabetes. Recent studies that SGLT2 inhibitor can also reduce in transaminase activities or hepatic fat content in NAFLD. NAFLD patients with type 2 diabetes can be indicated for SGLT2 inhibitor, because they are obese, have insulin resistance, and at high risk of cardiovascular events. The phase 3 study of dapagliflozin for NAFLD (DEAN study) is now ongoing. It remains unknown whether this agent can ameliorate hepatic fibrosis in NASH, leading to improved over-all or liver-related survival. Since the leading cause of NAFLD mortality is cardiovascular events, SGLT2 inhibitors will become the 1st line treatment for NAFLD/NASH.
Citation: Sumida Y, Yoneda M, Tokushige K, Kawanaka M, Fujii H, Yoneda M, Imajo K, Takahashi H, Ono M, Nozaki Y, Hyogo H, Koseki M, Yoshida Y, Kawaguchi T, Kamada Y, Eguchi Y, Okanoue T, Nakajima A; Japan Study Group of NAFLD (JSG-NAFLD). Hepatoprotective Effect of SGLT2 Inhibitor on Nonalcoholic Fatty Liver Disease. Diab Res Open Access. 2020 Mar 05;2(S1):17-25.
Copyright © 2020 Sumida Y, Yoneda M, Tokushige K, Kawanaka M, Fujii H, Yoneda M, Imajo K, Takahashi H, Ono M, Nozaki Y, Hyogo H, Koseki M, Yoshida Y, Kawaguchi T, Kamada Y, Eguchi Y, Okanoue T, Nakajima A; Japan Study Group of NAFLD (JSG-NAFLD). This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Nonalcoholic Fatty Liver Disease; Sodium-glucose Cotransporter 2; Glucagon like Peptide-1; Hepatic Fibrosis; Hepatocarcinogenesis