SGLT2 Inhibitor Use and Cardiorenal Outcomes in Type 2 Diabetes With Liver Cirrhosis
Authors' conclusion
In this cohort study of patients with T2D and liver cirrhosis, the use of SGLT2is was associated with substantially lower risks of adverse kidney, cardiovascular, and hepatic outcomes compared with DPP4is. These findings suggested significant cardiorenal and hepatic protection for SGLT2is in this high-risk population.
Study context
- Population
- Adults with T2D and liver cirrhosis initiating SGLT2i or DPP-4i, Taiwan's National Health Insurance Database, May 2016–December 2023; mean (SD) age 64.68 (11.95) years, 33.92% female
- Participants
- 24,259 adults
- Exposure
- SGLT2i vs DPP-4i use
- SGLT2in = 9,689
- DPP-4in = 14,570reference
- Outcome
- End-stage kidney disease (ESKD), acute kidney injury (AKI), and major adverse cardiovascular events (MACE)
- Follow-up
- Median (IQR) 2.3 (1.0-4.0) years
Methodological detailsnationwide, inverse probability of treatment weighting
- Nationwide
- Inverse probability of treatment weighting
Main finding
As reported in the abstract
ESKD, AKI and MACE · median follow-up 2.3 years
Each group vs DPP-4iEstimate (95% CI)
SGLT2i
aHR (ESKD) 0.34(0.25–0.47)
SGLT2i
aHR (AKI) 0.66(0.59–0.74)
SGLT2i
aHR (MACE) 0.67(0.62–0.71)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aHR (95% CI) | |
|---|---|---|
| All-cause mortality | 0.58 (0.53–0.63) | |
| Hepatic decompensation events | 0.65 (0.57–0.74) | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
SGLT2 Inhibitor Use and Cardiorenal Outcomes in Type 2 Diabetes With Liver Cirrhosis. JAMA Netw Open. Published 2 February 2026. doi:10.
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