SGLT2 inhibitors and incretin agents: Associations with alanine aminotransferase activity in type 2 diabetes.

Diabetes & Metabolism
H S BajajRonnie Aronson

Abstract

The impact of new classes of glucose lowering medications on markers of non-alcoholic fatty liver disease (NAFLD) associated with type 2 diabetes (T2D) have been inconsistent in their magnitude and independence. This large retrospective study investigates changes in alanine aminotransferase (ALT) levels among subjects initiated on newer classes of T2D medications in comparison to a reference control group. We studied people with T2D from a large Canadian diabetes register, who had canagliflozin, dapagliflozin, liraglutide, sitagliptin or no further treatment added to their diabetes treatments. Stepwise multiple regression was used to determine the association of A1c and weight change on ALT. Propensity score weighting was used to balance baseline characteristics between treatment groups. A total of 3667 subjects met study criteria. ALT levels (mean follow-up 4.8 months) were lower after treatment with sodium glucose co-transporter 2 (SGLT2) inhibitors, canagliflozin (-4.3U/L, P<0.01) and dapagliflozin (-3.5U/L, P<0.01), compared to incretin agents, liraglutide (-2.1U/L, P<0.01) and sitagliptin (-1.8U/L, P<0.01), each greater than the control group. Only the SGLT2 inhibitor treatment groups maintained a significant ALT reduction...Continue Reading

Citations

Feb 19, 2020·Diabetes Technology & Therapeutics·Kavita GargSatish K Garg
Jan 27, 2021·Liver International : Official Journal of the International Association for the Study of the Liver·Santo ColosimoLoris Pironi
Jan 14, 2021·Journal of Gastroenterology and Hepatology·Lampros ChrysavgisEvangelos Cholongitas
Apr 23, 2021·Expert Review of Clinical Pharmacology·Elizabeth M LamosStephen N Davis
Jun 17, 2021·Nature Reviews. Endocrinology·Daniel Ferguson, Brian N Finck
Sep 18, 2021·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Katsutoshi TokushigeKazuhiko Koike
Sep 18, 2021·Journal of Gastroenterology·Katsutoshi TokushigeKazuhiko Koike

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