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Effect of Dapagliflozin on Fatty Liver Improvement in Type 2 Diabetes Patients with Nonalcoholic Fatty Liver Disease
J. Kor. Soc. Health-syst. Pharm. 2021;38:18-29
Published online February 28, 2021;
© 2021 Korean Society of Health-System Pharmacists

Mijin Lee*, Sang Hyun Park*, Hyunjung Hwang, Insang Yoon and Kyung Hee Choi

College of Pharmacy, Sunchon National University, 255 Jungangno, Suncheon, Jeonnam, 57922, Republic of Korea
Correspondence to: †교신저자 최경희 Tel:061-750-3763
*이미진과 박상현은 공동 제1저자로서 본 논문에 동등하게 기여함
Received October 23, 2020; Revised November 24, 2020; Accepted December 16, 2020.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background : The global prevalence of type 2 diabetes mellitus (T2DM) is rapidly growing worldwide, and accordingly, the number of patients with concomitant diseases is increasing. Type 2 diabetes mellitus is closely related to nonalcoholic fatty liver disease (NAFLD), and in this study, a meta-analysis was conducted to investigate the effect of dapagliflozin on improving liver enzyme levels in NAFLD patients taking.
Methods : This study identified eligible trials based on MeSH terms in the PubMed, EMBASE, and CENTRAL database published from 2012 to March 2020 that reported effects on liver outcomes in patients with type 2 diabetes. The primary outcomes were alanine aminotransferase (ALT), aspartate aminotransferase (AST), and fibrosis-4 (FIB-4) index scores and the second outcomes were body mass index (BMI), and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels. For the statistical analysis, standardized mean difference (SMD) was calculated at 95% confidence intervals (CIs), and fixed or random-effects models were used to assess the outcomes.
Results : From the 423 records identified, seven articles with a total of 795 patients met the inclusion criteria and were analyzed. Compared to the placebo or other diabetes medication groups, patients treated with dapagliflozin showed significantly decreased adjusted mean change in ALT levels (p=0.0002, SMD=-0.39), but no major difference was found in AST levels (p=0.10, SMD=-0.24) or FIB-4 index scores (p=0.19, SMD=-0.11). BMI (p=0.008, SMD=-1.20) was significantly decreased, but the HDL and LDL cholesterol levels showed no major differences.
Conclusion : Reductions in the ALT levels and BMI by dapagliflozin suggest that it may help prevent liver damage in type 2 diabetes patients with NAFLD. Although more research is needed, dapagliflozin may be a suitable treatment strategy for T2DM patients with non-alcoholic fatty liver, which will provide a clinical reference for the treatment of T2DM.
Keywords : Type 2 diabetes mellitus, Dapagliflozin, Non-alcoholic fatty liver disease, Meta-analysis

February 2021, 38 (1)