Hormonal
SGLT2 inhibitors reduce hepatic lipid content and liver enzymes in patients with MASLD and Type 2 Diabetes, but histological evidence for treating MASH is still required.
If you have diabetes and fatty liver, SGLT2 inhibitors (like dapagliflozin) are a good option to lower liver fat and enzymes. They work by changing how your body handles sugar and fat. However, they are not yet proven to reverse the scarring of MASH, so they are part of a broader management strategy.
SGLT2i has the potential to treat MASH through four main mechanisms: decreasing hepatic de novo lipogenesis... increasing fatty acid β-oxidation... suppressing glucose-induced oxidative stress, and inhibiting liver fibrosis... Dapagliflozin (10 mg for 12 weeks) significantly reduced intrahepatic lipid content and ALT... Overall, SGLT2is are effective in controlling glycemic levels and lowering hepatic lipid content, but histological analyses are necessary to evaluate their effects on MASH.
Why this rating
Based on biochemical improvements and small histological studies, but explicitly stated that histological analysis for MASH is still necessary.
Source
Pipeline of New Drug Treatment for Non-alcoholic Fatty Liver Disease/Metabolic Dysfunction-associated Steatotic Liver Disease
Ye Hu et al. · Journal of Clinical and Translational Hepatology · 2024
DOI 10.14218/jcth.2024.00123
More from this paper
- GLP-1 receptor agonists (e.g., semaglutide, liraglutide) and dual/triple incretin agonists (e.g., tirzepatide, retatrutide) significantly reduce hepatic steatosis and liver enzymes in patients with MASLD, primarily through indirect mechanisms of weight loss and improved insulin resistance, though they may not consistently resolve fibrosis.Good
- FXR agonists (e.g., obeticholic acid) improve MASH histology but are limited by side effects like pruritus and increased LDL cholesterol.Good
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