Empagliflozin is associated with improvements in liver enzymes potentially consistent with reductions in liver fat: results from randomised trials including the EMPA-REG OUTCOME® trial.
Empagliflozin is associated with improvements in liver enzymes potentially consistent with reductions in liver fat: results from randomised trials including the EMPA-REG OUTCOME® trial.
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DOI：
10.1007/s00125-018-4702-3
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发表时间：
2018-10
期刊：
影响因子：
8.2
通讯作者：
Zinman B
中科院分区：
文献类型：
--
作者：
Sattar N;Fitchett D;Hantel S;George JT;Zinman B
除了对血糖和心血管死亡有好处外，埃帕利福秦还可以改善肥胖指数。我们研究了依帕格列酮对2型糖尿病患者转氨酶(与肝脏脂肪相关)的影响。基线丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)的变化在EMPA-REG结果®试验(n = 7020)、4个为期24周的安慰剂对照试验(n = 2477)和超过104周的埃帕利福与格列美脲试验(n = 1545)中进行了评估。分析使用来自所有参与者的数据，并按基线转氨酶的三分位数进行。在EMPA-REG OUSULT®试验中，28周时与基线ALT相比的平均SE变化分别为−2.96 ± 0.18和−0.73 ± 0.25U/L(调整后的平均差异：−2.22[95%CI−2.83，−1.62]；p <； 0.0001)。ALT降幅最大的是ALT最高的三分位数(第28周经安慰剂调整的平均差值：−4.36U/L[95%CI−5.51，−3.21]；p <； 0.0001)。在合并的24周数据中，调整后的ALT变化平均差值在第24周时为−3.15U/L(95%CI−4.11，−2.18)，与安慰剂相比，在第28周时为−4.88U/L(95%CI−6.68，−3.09)。ALT的降低在很大程度上与体重或HbA1c的变化无关。AST的变化模式与ALT相似，但下降幅度要低得多。这些高度一致的结果表明，在2型糖尿病患者中，empagliflzin降低了转氨酶，其模式(ALT>；AST的降低)可能与肝脏脂肪的减少一致，特别是当ALT水平较高时。这篇文章的在线版本(10.1007/s00125.0184702-3)包含经同行审查但未经编辑的补充材料，授权用户可以使用。
In addition to beneficial effects on glycaemia and cardiovascular death, empagliflozin improves adiposity indices. We investigated the effect of empagliflozin on aminotransferases (correlates of liver fat) in individuals with type 2 diabetes. Changes from baseline alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were assessed in the EMPA-REG OUTCOME® trial (n = 7020), pooled data from four 24-week placebo-controlled trials (n = 2477) and a trial of empagliflozin vs glimepiride over 104 weeks (n = 1545). Analyses were performed using data from all participants and by tertiles of baseline aminotransferases. In the EMPA-REG OUTCOME® trial, mean ± SE changes from baseline ALT at week 28 were −2.96 ± 0.18 and −0.73 ± 0.25 U/l with empagliflozin and placebo, respectively (adjusted mean difference: −2.22 [95% CI −2.83, −1.62]; p < 0.0001). Reductions in ALT were greatest in the highest ALT tertile (placebo-adjusted mean difference at week 28: −4.36 U/l [95% CI −5.51, −3.21]; p < 0.0001). The adjusted mean difference in change in ALT was −3.15 U/l (95% CI −4.11, −2.18) with empagliflozin vs placebo at week 24 in pooled 24-week data, and −4.88 U/l (95% CI −6.68, −3.09) with empagliflozin vs glimepiride at week 28. ALT reductions were largely independent of changes in weight or HbA1c. AST changes showed similar patterns to ALT, but the reductions were considerably lower. These highly consistent results suggest that empagliflozin reduces aminotransferases in individuals with type 2 diabetes, in a pattern (reductions in ALT>AST) that is potentially consistent with a reduction in liver fat, especially when ALT levels are high. The online version of this article (10.1007/s00125-018-4702-3) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
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非酒精性脂肪肝。
DOI：
10.1136/bmj.g4596
发表时间：
2014-07-29
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Sattar N;Forrest E;Preiss D
通讯作者：
Preiss D
影响因子：
1.6
作者：
Dai W;Ye L;Liu A;Wen SW;Deng J;Wu X;Lai Z
通讯作者：
Lai Z
影响因子：
6.7
作者：
Leite, Nathalie C.;Salles, Gil F.;Cardoso, Claudia R. L.
通讯作者：
Cardoso, Claudia R. L.
影响因子：
16.2
作者：
Rosenstock, Julio;Jelaska, Ante;Broedl, Uli C.
通讯作者：
Broedl, Uli C.
影响因子：
44.5
作者：
Ridderstrale, Martin;Andersen, Knut Robert;Broedl, Uli C.
通讯作者：
Broedl, Uli C.