Glucose-lowering drugs and liver-related outcomes among individuals with type 2 diabetes: A systematic review of longitudinal population-based studies

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Diabetic Medicine Pub Date : 2024-09-28 DOI:10.1111/dme.15437

Shaghayegh Khanmohammadi, Amirhossein Habibzadeh, A. B. M. Kamrul-Hasan, Art Schuermans, Mohammad Shafi Kuchay

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Abstract

Aims

While randomized controlled trials data on the long-term effect of glucose-lowering drugs (GLDs) on liver-related outcomes are lacking, population-based studies have evaluated the associations of GLDs with liver-related outcomes in individuals with type 2 diabetes (T2D). we aimed to conduct a systematic review of population-based studies evaluating the effects of GLDs on liver-related outcomes in people with T2D.

Methods

PubMed, Web of Science, and Embase databases were systematically searched for population-based studies testing the associations of GLDs with liver-related outcomes in individuals with T2D and no liver disease other than non-alcoholic fatty liver disease (NAFLD) from inception to 23 February 2024. GLDs included SGLT2is, TZDs, insulin, GLP-1 RAs and dipeptidyl peptidase-4 inhibitors (DPP4Is).

Results

Ten cohort studies, comprising 1,274,641 participants, met the inclusion criteria. The median follow-up period ranged from 8.9 to 76 months. Of all the GLDs under investigation, SGLT2is were associated with the strongest reduction in NAFLD incidence, cirrhosis, and composite liver-related events compared to other medications. TZDs were associated with a reduced risk of developing NAFLD and cirrhosis but were not significantly associated with a lower incidence of hepatocellular carcinoma. GLP-1 RAs demonstrated a significant association with reduced liver-related mortality.

Conclusions

Observational data from population-based studies suggest that GLDs such as SGLT2is are associated with beneficial long-term liver-related outcomes in T2D patients with NAFLD. Additional studies, including randomized controlled trials with long-term follow-up, are needed to confirm these findings.

Registration Number

PROSPERO CRD442024536872.

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降糖药物与 2 型糖尿病患者的肝脏相关结果：以人群为基础的纵向研究的系统回顾。

目的：虽然缺乏降糖药物（GLDs）对肝脏相关结果长期影响的随机对照试验数据，但基于人群的研究评估了GLDs与2型糖尿病（T2D）患者肝脏相关结果的关联：我们在 PubMed、Web of Science 和 Embase 数据库中系统地检索了从开始到 2024 年 2 月 23 日检测 GLDs 与 T2D 患者肝脏相关结果的相关性的人群研究。GLDs包括SGLT2is、TZDs、胰岛素、GLP-1 RAs和二肽基肽酶-4抑制剂（DPP4Is）：有 10 项队列研究符合纳入标准，共有 1,274,641 人参与。中位随访时间从 8.9 个月到 76 个月不等。在所有接受调查的 GLDs 中，与其他药物相比，SGLT2 类药物能最大程度地降低非酒精性脂肪肝的发病率、肝硬化和肝脏相关综合事件。TZDs 与非酒精性脂肪肝和肝硬化发病风险的降低有关，但与肝细胞癌发病率的降低无显著相关性。GLP-1 RAs与降低肝脏相关死亡率有显著相关性：来自人群研究的观察数据表明，GLDs（如 SGLT2is）与患有非酒精性脂肪肝的 T2D 患者的长期肝脏相关结果有关。还需要更多的研究，包括长期随访的随机对照试验，来证实这些发现：PROPERCO CRD442024536872。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”