ArticleLiver international : official journal of the International Association for the Study of the Liver2021
Effects of antidiabetic agents on steatosis and fibrosis biomarkers in type 2 diabetes: A real-world data analysis.
Article in Liver international : official journal of the International Association for the Study of the Liver, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 43 citations in OpenAlex.
- GLP-1 Receptor Agonists in Metabolic Dysfunction-Associated Steatotic Liver Disease: Bridging Hepatic and Cardiovascular Outcomes.Chronic diseases and translational medicine · 2026Review
- Metabolic Dysfunction-Associated Steatotic Liver Disease and Incretin Receptor Agonists: A Metabolic Approach to Halting Liver Disease Progression.Medicina (Kaunas, Lithuania) · 2026Review
- Article
- Real-world comparison of GLP-1 agonists versus physical activity in metabolic dysfunction-associated steatotic liver disease.BMC gastroenterology · 2026Article
- SGLT2 Inhibitors Modify Fibrosis-4 Index and Mitigate the Development of DKD: Role of Background Antidiabetic Drugs.Journal of the Endocrine Society · 2025Article
- The effect of SGLT2 inhibitors on hepatic steatosis detected by MRI-PDFF in patients with type 2 Diabetes mellitus and metabolic-associated steatotic liver disease.Internal and emergency medicine · 2025Article
- Glucagon-like peptide-1 receptor agonists improve metabolic dysfunction-associated steatotic liver disease outcomes.Scientific reports · 2025Article
- MAFLD Pandemic: Updates in Pharmacotherapeutic Approach Development.Current issues in molecular biology · 2024Review
- Fatty liver index (FLI): more than a marker of hepatic steatosis.Journal of physiology and biochemistry · 2024Review
- The role of anti-diabetic drugs in NAFLD. Have we found the Holy Grail? A narrative review.European journal of clinical pharmacology · 2024Review
- Diet and physical exercise as key players to tackle MASLD through improvement of insulin resistance and metabolic flexibility.Frontiers in nutrition · 2024Review
- Biomarkers for Assessing Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus on Sodium-Glucose Cotransporter 2 Inhibitor Therapy.Journal of clinical medicine · 2023Review
- Hepatic insulin receptor: new views on the mechanisms of liver disease.Metabolism: clinical and experimental · 2023Review
- Osteosarcopenia in NAFLD/MAFLD: An Underappreciated Clinical Problem in Chronic Liver Disease.International journal of molecular sciences · 2023Review
- Performance of Simple Fibrosis Score in Non-Alcoholic Fatty Liver Disease with and without Type 2 Diabetes.Endocrinology and metabolism (Seoul, Korea) · 2023Article
- Improved glycaemic control in patients with type 2 diabetes has a beneficial impact on NAFLD, independent of change in BMI or glucose lowering agent.Nutrition, metabolism, and cardiovascular diseases : NMCD · 2023Article
- GLP-1 Receptor Agonists in Non-Alcoholic Fatty Liver Disease: Current Evidence and Future Perspectives.International journal of molecular sciences · 2023Review
- Advancements in the treatment of non-alcoholic fatty liver disease (NAFLD).Frontiers in endocrinology · 2022Review
- Association between use of liraglutide and liver fibrosis in patients with type 2 diabetes.Frontiers in endocrinology · 2022Article
- Nutrition in Patients with Type 2 Diabetes: Present Knowledge and Remaining Challenges.Nutrients · 2021Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsThere is intense research for drugs able to reduce disease progression in nonalcoholic fatty liver disease. We aimed to test the impact of novel antidiabetic drugs (dipeptidyl-peptidase-4 inhibitors - DPP-4Is, glucagon-like peptide-1 receptor agonists - GLP-1RAs, sodium-glucose cotransporter-2 inhibitors - SGLT-2Is) on non-invasive biomarkers of steatosis (fatty liver index, FLI) and fibrosis (Fibrosis-4 score, FIB-4) in patients with type 2 diabetes (T2D).
methodsClinical, anthropometric and biochemical parameters were retrospectively analysed in 637 consecutive T2D patients switched from metformin w/wo sulfonylureas and/or pioglitazone to DPP-4Is, GLP-1RAs and SGLT-2Is in a tertiary care setting. 165 patients maintained on original treatments served as controls. The effects on FLI and FIB-4 at 6- and 12-month follow-up were analysed by logistic regression after adjustment for baseline differences, computed by propensity scores, and additional adjustment for changes in glycosylated hemoglobin (HbA1c) and body mass index.
resultsBody mass index, HbA1c and aminotrasferases significantly decreased following switching to GLP-1RAs and SGLT2-Is, compared with both controls and DPP-4Is, whereas only HbA1c was reduced on DPP-4Is. FLI and FIB-4 were reduced on GLP-1RA and SGLT-2I; logistic regression analysis confirmed a significant improvement of both biomarkers after adjustment for propensity score. The shift of FIB-4 values towards the category ruling out advanced fibrosis was maintained after additional adjustment for confounders. These effects were confirmed in a sensitivity analysis on effect size.
conclusionsGlucagon-like peptide-1 receptor agonists and SGLT-2Is improve biomarkers of steatosis and fibrosis, in keeping with beneficial effects on liver disease progression, and should be considered the treatment of choice in T2D.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.