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Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2019; 11(7): 562-573
Published online Jul 27, 2019. doi: 10.4254/wjh.v11.i7.562
Rise of sodium-glucose cotransporter 2 inhibitors in the management of nonalcoholic fatty liver disease
Amr Dokmak, Mohammad Almeqdadi, Hirsh Trivedi, Sandeep Krishnan
Amr Dokmak, Mohammad Almeqdadi, Division of Medicine, St. Elizabeth’s Medical Center, Brighton, MA 02135, United States
Amr Dokmak, Mohammad Almeqdadi, Sandeep Krishnan, Tufts University School of Medicine, Boston, MA 02111, United States
Hirsh Trivedi, Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA 02215, United States
Sandeep Krishnan, Division of Gastroenterology, St. Elizabeth’s Medical Center, Brighton, MA 02135, United States
Author contributions: Dokmak A and Almeqdadi M contributed equally to the paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version; Trivedi H contributed to the drafting and critical revision; Krishnan S contributed to the literature review, critical revision, editing and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Sandeep Krishnan, MBBS, MD, Chief Physician, Division of Gastroenterology, St. Elizabeth’s Medical Center, 736 Cambridge Street, Brighton, MA 02135, United States. sandeep.krishnan@steward.org
Telephone: +1-617-5625432 Fax: +1-617-7796763
Received: March 22, 2019
Peer-review started: March 25, 2019
First decision: June 3, 2019
Revised: June 12, 2019
Accepted: June 27, 2019
Article in press: June 27, 2019
Published online: July 27, 2019
Processing time: 126 Days and 18.3 Hours
Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease in the Western world. It is more prevalent in male gender, and with increasing age, obesity, and insulin resistance. Besides weight loss, there are limited treatment options. The use of anti-diabetic medications has been studied with mixed results. In this review, we discuss the use of anti-diabetic medications in the management of NAFLD with a specific focus on sodium-glucose cotransporter 2 inhibitors. We shed light on the evidence supporting their use in detail and discuss limitations and future directions.

Keywords: Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Sodium-glucose cotransporter 2 inhibitors; Liver cirrhosis; Diabetes

Core tip: Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease in the Western world. NAFLD is associated with obesity and insulin resistance. Weight loss is the cornerstone of therapy with no other proven pharmacologic therapy, Sodium-glucose co-transporter 2 (SGLT2) inhibitors may play a role in preventing and treating NAFLD. SGLT2 inhibitors reduce hepatic steatosis, steatohepatitis, and fibrosis in patients with NAFLD.