Impact of sodium-glucose co-transporter 2 inhibitor for non-alcoholic fatty liver disease complicated by diabetes mellitus ―Prospective study based on the serial liver biopsy―

Abstract

A prospective study based on the serial liver biopsy was performed to investigate the efficacy of sodiumglucose co-transporter 2 (SGLT2) inhibitor for NAFLD complicated by type 2 diabetes mellitus. 2 patients were introduced the regimen of canagliflozin 100 mg once daily for 24 weeks, and could be evaluated liver histology at the two points of the pretreatment and 24 weeks after the start of treatment. In both of patients, hepatocyte steatosis grade and NAFLD activity score improved at 24 weeks, compared to the pretreatment. Furthermore, physical examination, glucose metabolism, serum ferritin levels, and findings of transient elastography also improved. In conclusion, a prospective study based on the serial liver biopsy indicated that SGLT2 inhibitor for NAFLD complicated by diabetes mellitus improved hepatocyte steatosis. Further large-scale and long-term studies are needed to determine the impact of SGLT2 inhibitor for histological features, including fibrosis stage.