Evidence mapPaperPMID 37938366Full record

ReviewEuropean journal of clinical pharmacology2024

The role of anti-diabetic drugs in NAFLD. Have we found the Holy Grail? A narrative review.

Maria Zachou, Pagona Flevari, Narjes Nasiri-Ansari, Constantinos Varytimiadis, Evangelos Kalaitzakis, Eva Kassi, Theodoros Androutsakos

Open access · hybridAbstract readReview
In one paragraph

Review in European journal of clinical pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
5.6field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 26 citations in OpenAlex.

  1. Article
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  9. Therapeutic Strategies for MASH: An Update on Drug Candidates Under Investigation in Late-Phase Clinical Trials.International journal of translational medicine (Basel, Switzerland) · 2025
    Article
  10. Review
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  15. Ethanol extract ofIranian journal of basic medical sciences · 2025
    Article
  16. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Maria ZachouGastroenterology Department, "Sismanoglio" General Hospital, 151 26, Athens, Greece.ORCID http://orcid.org/0000-0001-5156-9553
Pagona FlevariExpertise Center in Rare Haematological Diseases-Haemoglobinopathies, "Laiko" General Hospital, 115 27, Athens, Greece.ORCID http://orcid.org/0000-0001-8638-7944
Narjes Nasiri-AnsariDepartment of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.ORCID http://orcid.org/0000-0002-0116-693X
Constantinos VarytimiadisGastroenterology Department, "Evangelismos" General Hospital, 106 76, Athens, Greece.ORCID http://orcid.org/0000-0002-6155-685X
Evangelos KalaitzakisDepartment of Gastroenterology, University Hospital of Heraklion, University of Crete, 715 00, Heraklion, Greece.ORCID http://orcid.org/0000-0002-9947-8914
Eva KassiUnit of Molecular Endocrinology, Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.ORCID http://orcid.org/0000-0001-7491-2297
Theodoros AndroutsakosDepartment of Pathophysiology, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, 115 27, Athens, Greece. tandroutsak@med.uoa.gr.ORCID http://orcid.org/0000-0003-2556-6230
National and Kapodistrian University of Athens · GREvangelismos Hospital · GRLaiko General Hospital of Athens · GRSismanoglio General Hospital · GRUniversity of Crete · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNon-alcoholic fatty liver disease (NAFLD) has become a leading cause of liver disease, affecting 30% of the global population. NAFLD prevalence is particularly high in obese individuals and patients with type 2 diabetes mellitus (T2DM). NAFLD ranges from simple fat deposition in the liver to necroinflammation and fibrosis (non-alcoholic steatohepatitis (NASH)), NASH-cirrhosis, and/or hepatocellular carcinoma. Insulin resistance plays a key role in NAFLD pathogenesis, alongside dysregulation of adipocytes, mitochondrial dysfunction, genetic factors, and changes in gut microbiota. Since insulin resistance is also a major predisposing factor of T2DM, the administration of anti-diabetic drugs for the management of NAFLD seems reasonable.

methodsIn this review we provide the NAFLD-associated mechanisms of action of some of the most widely used anti-diabetic drugs, namely metformin, pioglitazone, sodium-glucose transport protein-2 inhibitors (SGLT2i), glucagon-like peptide 1 receptor analogs (GLP1 RAs), and dipeptyl-peptidase-4 inhibitors (DPP4i) and present available data regarding their use in patients with NAFLD, with and without T2DM.

resultsBoth metformin and DPP4i have shown rather contradictory results, while pioglitazone seems to benefit patients with NASH and is thus the only drug approved for NASH with concomitant significant liver fibrosis by all major liver societies. On the other hand, SGLT2i and GLP1 RAs seem to be beneficiary in patients with NAFLD, showing both remarkable results, with SGLT2i proving to be more efficient in the only head-to-head study so far.

conclusionIn patients with NAFLD and diabetes, pioglitazone, GLP1 RAs, and SGLT2i seem to be logical treatment options. Larger studies are needed before these drugs can be recommended for non-diabetic individuals.

Indexed as

Diabetes Mellitus, Type 2Insulin ResistanceMetforminNon-alcoholic Fatty Liver DiseaseHumansHypoglycemic AgentsLiver CirrhosisPioglitazoneHypoglycemic AgentsMetforminPioglitazoneGlucagon-like peptide-1Metabolic associated fatty liver diseaseMetforminNon-alcoholic fatty liver diseasePioglitazoneSodium-glucose transporter inhibitors

Identifiers

PMID37938366
PMCPMC10781828
OpenAlexW4388500169

What Socratic holds

Texttitle and abstract
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.