Improvement effect of dapagliflozin on liver function in patients with type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease and its mechanism / 吉林大学学报(医学版)

ABSTRACT

Objective: To investigate the effect of dapagliflozin on the liver function of the patients with type 2 diabetes mellitus (T2DM) complicated with non-alcoholic fatty liver disease (NAFLD), and to analyze its improvement effect on liver injury of the T2DM patients. Methods: The clinical data of 68 T2DM patients complicated with NAFLDS who did not receive any treatment were retrospectively analyzed, including 30 patients in acarbose group and 38 patients in dapagliflozin group, and the patients in two groups received acarbose 150 mg · d-1 + metformin 2 000 mg · d-1 and dapagliflozin 10 mg · d-1 + metformin 2 000 mg · d-1 treatment for 24 weeks, respectively. The general data of the patients before and after treatment were collected. The fasting venous blood of the patients in two groups was collected and the serum biochemical indexes and liver function indexes were detected. The serum biochemical indexes included fasting blood glucose (FBG) and glycosylated hemoglobin (HbAlc), and the homeostasis model assessment 2-insulin resistance index (HMOA2-IR) was calculated. The liver function indexes included aspartic transaminase (AST), alanine aminotransferase (ALT), glutamyltranspeptidase (GGT), alkaline phosphatase (ALP), total bilirubin (TBIL), and direct bilirubin (DBIL); the non-alcoholic fatty liver disease fibrosis score (NAFLDFS) was calculated. The each detection index of the patients in two groups was compared and analyzed. Results: Compared with before treatment, the levels of FBG, HbAlc, AST, GGT, and ALP and HOMA2-IR in acarbose group after treatment were significantly decreased (P<0.01) and the levels of TBIL was significantly increased (P<0.01). Compared with before treatment, the levels of FBG, HbAlc, AST, ALT, GGT, and ALP and HOMA2-IR, NAFLDFS in dapagliflozin group were significantly decreased after treatment (P<0.01) and the levels of TBIL and DBIL were significantly increased (P<0.01). The levels of FBG, AST, ALT, GGT, and ALP and NAFLDF in dapagliflozin group after treatment were significantly decreased compared with acarbose group (P<0.01). Conclusion: Dagliflozin can improve the liver function of the patients with T2DM complicated with NAFLD, and its mechanism may be related to the effect of dapagliflozin decreasing the blood glucose and body weight.