Takeaway
- In patients with type 2 diabetes (T2D), the current use of thiazolidinediones (TZDs) was associated with a lower risk of non-alcoholic fatty liver disease (NAFLD) compared with the current use of sulphonylureas (SUs).
- However, the current use of glucagon-like peptide-1 (GLP-1) receptor agonists was not associated with a lower risk of NAFLD compared with the current use of insulins.
Why this matters
- Findings support the use of TZDs for selected patients at higher risk of NAFLD but do not support previous findings concerning the beneficial effect of GLP-1 receptor agonists in this population.
Study design
- A population-based cohort study included 207,367 patients with T2D (age, ≥18 years) from the UK Clinical Practice Research Datalink who were prescribed glucose-lowering agents and followed up for a mean of 5.1 years.
- Primary outcome: incident NAFLD; secondary outcome: incident hepatocellular carcinoma (HCC).
- Funding: None disclosed.
Key results
- Patients with T2D receiving TZDs vs those receiving SUs had a lower risk of NAFLD (adjusted HR [aHR], 0.32; 95% CI, 0.20-0.51).
- There was no difference in the risk of NAFLD between patients with T2D who were prescribed GLP-1 receptor agonists and insulin (aHR, 1.22; 95% CI, 0.91-1.63).
- Incidence rates of HCC per 1000 person-years were:
- 0.1 for the use of GLP-1 receptor agonists;
- 0.4 for the use of insulins; and
- 0.5 for combined use of GLP-1 receptor agonists and insulins.
Limitations
- Low number of NAFLD events in several subgroups may affect the generalisability of results.
This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.