Non-alcoholic fatty liver disease risk with GLP-1 receptor agonists and SGLT-2 inhibitors in type 2 diabetes: a nationwide nested case–control study
Authors' conclusion
GLP-1RA and SGLT2i therapies in type 2 diabetes patients might prevent NAFLD/NASH development, with a significantly lower risk related to greater treatment exposure.
Study context
- Population
- Patients aged ≥40 years with T2D, stable non-insulin glucose-lowering agent use and no NAFLD/non-alcoholic steatohepatitis (NASH) history; Taiwan National Health Insurance Research Database, 2011–2018study cohort
- Participants
- 621,438 patients
- Comparison
- GLP-1 RA or SGLT2i use vs non-use
- Casesn = 5,730
- Controlsn = 45,070reference
- Outcome
- Incident NAFLD/NASH
- Follow-up
- Median 1.8 years
Methodological detailsnationwide, matched up to 10 controls per case on age, gender, cohort entry date, T2D diagnosis date and disease risk score, conditional logistic regression, dose-response analysis
- Nationwide
- Matched up to 10 controls per case on age, gender, cohort entry date, T2D diagnosis date and disease risk score
- Conditional logistic regression
- Dose-response analysis
Main finding
As reported in the abstract
NAFLD/NASH risk
Odds ratio (95% CI)
GLP-1RAs
0.84(0.46–1.52)
SGLT2is
0.85(0.63–1.14)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate |
|---|---|
| Dose-response: increased cumulative SGLT2i dosesSignificantly reduced NAFLD/NASH risk | 0.61 (CI 0.38–0.97) |
Incidence of NAFLD/NASH in study cohort · median follow-up 1.8 years
- Incidence of NAFLD/NASH
- 2.7 per 1000 person-years
Original publication
Non-alcoholic fatty liver disease risk with GLP-1 receptor agonists and SGLT-2 inhibitors in type 2 diabetes: a nationwide nested case–control study. Cardiovasc Diabetol. Published 17 October 2024. doi:10.
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