Factors with remission of fatty liver in patients with type 2 diabetes treated with ipragliflozin

• Published in: Endocrine Journal 2019, Vol.66(11), pp.995-1000
• Main Authors: Yamauchi, Yuki, Nakamura, Akinobu, Takahashi, Kiyohiko, Takase, Takahiro, Yamamoto, Chiho, Yokota, Isao, Atsumi, Tatsuya, Miyoshi, Hideaki
• Format: Article
• Language: English
• Subjects: Aged; Alanine; Alanine transaminase; Alcohol use; Aspartate aminotransferase; Body Mass Index; Body weight; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Fatty liver; Fatty Liver - blood; Fatty Liver - complications; Female; gamma-Glutamyltransferase - blood; Glucosides - therapeutic use; Humans; Ipragliflozin; Liver; Male; Middle Aged; Remission; Remission Induction; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; Thiophenes - therapeutic use; Treatment Outcome; Triglycerides - blood; Waist Circumference
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.EJ19-0136

We investigated the factors associated with fatty liver remission via treatment with ipragliflozin. The analysis was obtained from our multi-center prospective observational study, including 200 Japanese patients with type 2 diabetes treated with ipragliflozin (50 mg/day) for 24 weeks. The extent of fatty liver was estimated using a fatty liver index (FLI). Based on the FLI after the treatment with ipragliflozin, patients were classified into remission group (FLI < 30) and non-remission group (FLI ≥ 30). After treatment with ipragliflozin for 24 weeks, FLI significantly improved from 64.5 ± 21.6 to 51.9 ± 26.5 (p < 0.01). Body weight, body mass index, waist circumference, aspartate aminotransferase, alanine aminotransferase, and FLI in the remission group were significantly lower compared with those of the non-remission group. Stepwise analysis showed that the baseline FLI (Odds ratio 0.86; 95% confidence interval 0.81–0.90, p < 0.01) was an independent factor associated with FLI remission. Using a receiver operating characteristic (ROC) analysis, the adequate cut-off value for the remission was 50. The area under the ROC curve was 0.93 with the sensitivity and specificity 84.6% and 90.1% respectively. In conclusion, ipragliflozin ameliorated fatty liver. These results suggest that patients with fatty liver with a lower FLI are more likely to attain remission by the treatment with ipragliflozin.