Lipids & metabolic liver disease
Outcomes of Various Classes of Oral Antidiabetic Drugs on Nonalcoholic Fatty Liver Disease
Authors' conclusion
The results of this cohort study suggest that physicians may lean towards prescribing SGLT2 inhibitors as the preferred OAD for individuals with NAFLD and T2D, considering their potential benefits in NAFLD regression and lower incidences of adverse liver-related outcomes. This observational study should prompt future research to determine whether prescribing practices might merit reexamination.
Study context
- Population
- Patients with T2D and concomitant nonalcoholic fatty liver disease (NAFLD), National Health Information Database, Korea; mean age 58.5 years, 53.6% male
- Participants
- 80,178 patients219,941 person-years
- Exposure
- SGLT2i, TZD or DPP-4i vs SU, each combined with metformin
- Outcome
- NAFLD regression assessed by the fatty liver index, and composite liver-related outcome (liver-related hospitalization, liver-related mortality, liver transplant, hepatocellular carcinoma)
Methodological detailsnonrandomized interventional, population-level national database, Fine-Gray model for competing risks
- Nonrandomized interventional
- Population-level national database
- Fine-Gray model for competing risks
Main finding
As reported in the abstract
NAFLD regression
Adjusted subdistribution hazard ratio (95% CI)
SGLT2ivs SU
1.99(1.75–2.27)
TZDvs SU
1.70(1.41–2.05)
DPP-4ivs SU
1.45(1.31–1.59)
SGLT2ivs TZD
1.40(1.12–1.75)
SGLT2ivs DPP-4i
1.45(1.30–1.62)
- Patients experiencing NAFLD regression
- 4102
Observational data: associations, not effects.
Original publication
Outcomes of Various Classes of Oral Antidiabetic Drugs on Nonalcoholic Fatty Liver Disease. JAMA Intern Med. Published 1 April 2024. doi:10.
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