Evidence mapPaperPMID 40289065Full record

ArticleJournal of diabetes2025

Adverse Liver and Renal Outcomes After Initiating SGLT-2i and GLP-1RA Therapy Among Patients With Diabetes and MASLD.

Arunkumar Krishnan, Carolin V Schneider, Diptasree Mukherjee, Tinsay A Woreta, Saleh A Alqahtani

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Article in Journal of diabetes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
field-weighted citation impact
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

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

5 authors.

Arunkumar KrishnanDepartment of Medicine, Wake Forest University School of Medicine, Winston Salem, North Carolina, USA.ORCID https://orcid.org/0000-0002-9452-7377
Carolin V SchneiderDepartment of Medicine III, Gastroenterology, Metabolic Diseases, and Intensive Care, University Hospital RWTH Aachen, Aachen, Germany.
Diptasree MukherjeeDepartment of Medicine, Apex Institute of Medical Science, Kolkata, West Bengal, India.
Tinsay A WoretaDivision of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Saleh A AlqahtaniOrgan Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextThe management of metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (T2DM) presents a significant clinical challenge, with a focus on preventing progression to liver and renal complications.

objectiveTo evaluate the liver and renal outcomes among new users of sodium-glucose cotransporter 2 inhibitors (SGLT2i) versus glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl peptidase-4 inhibitors (DPP4i) and other anti-diabetic medications in patients with MASLD and T2DM.

designRetrospective cohort study.

settingElectronic health records.

participantsA total number of 88 306 patients with MASLD and T2DM were included in a propensity score-matched analysis comparing the effects of anti-diabetic drugs.

interventionPatients were categorized into groups based on their initiation of anti-diabetic medications.

main outcome measuresThe primary outcomes were the incidence of cirrhosis, hepatic decompensations, and hepatocellular carcinoma. Secondary outcomes were a progression of chronic kidney disease (CKD), severity of CKD stages, and the need for hemodialysis.

resultsIn the SGLT2i versus DPP4i, a reduced risk of cirrhosis was observed in the SGLT2i (HR: 0.97), along with fewer hepatic decompensations (HR: 0.84) and a lower incidence of HCC (HR: 0.50). CKD progression, particularly to stages 4-5, was significantly lower in the SGLT2i (HR: 0.53), as was hemodialysis (HR: 0.38). However, SGLT2i exhibited a slightly lower risk of CKD progression (HR: 0.77) and a reduced need for hemodialysis (HR: 0.71) compared to the GLP-1RA, while there was no difference in hepatic outcomes between the GLP-1RA and SGLT2i.

conclusionsSGLT2 inhibitors in patients with MASLD and T2DM demonstrated reduced risks of liver complications and a favorable impact on renal outcomes. These findings support the preferential consideration of SGLT2i in managing this patient population, particularly for mitigating the progression of liver and kidney diseases.

Indexed as

Diabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsNon-alcoholic Fatty Liver DiseaseRenal Insufficiency, ChronicSodium-Glucose Transporter 2 InhibitorsAgedDisease ProgressionFemaleHumansLiver CirrhosisMaleMiddle AgedRetrospective StudiesTreatment OutcomeDipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitorschronic kidney diseasecirrhosisDPP4 inhibitorsGLP1hepatocellular carcinomaliver outcomesMASLDrenal outcomesSGLT2 inhibitorsT2DM

Identifiers

PMID40289065
PMCPMC12034490

What Socratic holds

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Registered trials

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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.