Prevalence of Fatty Liver Screening and Predictive Factors for the Efficacy of SGLT2 Inhibitor Treatment in Diabetic Patients

Abstract

 Background: The study aimed to assess the prevalence of fatty liver screening and identify predictive factors for the efficacy of SGLT2 inhibitor treatment in diabetic patients.

 Methods: A total of 916 SLD patients who received SGLT2 inhibitors for more than 6 months since 2014 were included. The rate of liver imaging tests before and after treatment was evaluated. Additionally, 263 diabetic patients with SLD who received SGLT2 inhibitors for over 1 year were analyzed for changes in platelet count, liver enzymes, liver function, and fibrosis markers before and after treatment.

 Results: The rate of liver imaging tests was 69.4%, and the prevalence of MASLD was 57.7%. Significant reductions in ALT, ALP, γGT, and ALBI score were observed after SGLT2 inhibitor treatment, while the FIB-4 index did not show improvement. Stratified analysis revealed that ALT, ALP, γGT, ALBI score, and FIB-4 index improved in the MASLD group, whereas γGT and FIB-4 index worsened in the MetALD group. Factors associated with a high FIB-4 index after 1 year, indicating non-improvement of liver fibrosis, included high pre-treatment FIB-4 index and high alcohol consumption.

 Conclusion: The importance of liver disease screening in diabetic patients is reaffirmed, with a need for appropriate treatment and evaluation of prognostic factors for MASLD patients. Further research is expected to clarify the effects and contribute to clinical application.