Evidence map›Paper›PMID 40331745›Full record

ArticleJournal of diabetes investigation2025

Liver function effects of SGLT2 inhibitor and GLP-1 receptor agonist combination treatment in patients with type 2 diabetes (post hoc analysis of RECAP study).

Daisuke Tsuriya, Kazuo Kobayashi, Kei Takeshita, Takuya Hashimoto, Moritsugu Kimura, Yoshimi Muta, Hisashi Yokomizo, Yuichi Takashi, Shunichiro Tsukamoto, Kouichi Tamura and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of diabetes investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Article
  7. Review
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Daisuke TsuriyaDivision of Endocrinology and Metabolism, 2nd Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Kazuo KobayashiDepartment of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.ORCID https://orcid.org/0000-0002-1284-9728
Kei TakeshitaDivision of Endocrinology and Metabolism, 2nd Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Takuya HashimotoDivision of Endocrinology and Metabolism, 2nd Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Moritsugu KimuraDivision of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan.
Yoshimi MutaDepartment of Endocrinology and Diabetes, Fukuoka University School of Medicine, Fukuoka, Japan.
Hisashi YokomizoDepartment of Endocrinology and Diabetes, Fukuoka University School of Medicine, Fukuoka, Japan.ORCID https://orcid.org/0000-0001-7759-2014
Yuichi TakashiDepartment of Endocrinology and Diabetes, Fukuoka University School of Medicine, Fukuoka, Japan.
Shunichiro TsukamotoDepartment of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Kouichi TamuraDepartment of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Keizo KanasakiDepartment of Internal Medicine 1, Endocrinology and Metabolism, Shimane University Faculty of Medicine, The Center for Integrated Kidney Research and Advance, Faculty of Medicine, Shimane University, Izumo, Japan.ORCID https://orcid.org/0000-0002-9563-502X
Daiji KawanamiDepartment of Endocrinology and Diabetes, Fukuoka University School of Medicine, Fukuoka, Japan.ORCID https://orcid.org/0000-0002-8926-4701
Masao ToyodaDivision of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimThe favor effect on liver disease by odium-glucose cotransporter inhibitor (SGLT2i) and GLP-1 receptor agonist (GLP1Ra) was reported; however, the effect of the combination treatment of these drugs was not well known.

methodsWe retrospectively analyzed data for 643 patients with type 2 diabetes receiving SGLT2i + GLP1Ra combination treatment for at least 1 year (331 and 312 patients in the GLP1Ra- and SGLT2i-preceding groups, respectively). Propensity score (PS) matching was used to compare the effects of the preceding drugs on liver function.

resultsThe mean AST and ALT values at baseline, at the initiation of combination treatment, and at final observation were 29.8 ± 20.0 and 37.7 ± 29.5, 28.7 ± 17.3 and 35.3 ± 6.0, 26.0 ± 14.6 and 30.1 ± 21.6 IU/L, respectively, indicative of significant improvements in liver function (P < 0.001). Conversely, significant progress in the fibrosis-4 (FIB-4) index category was observed even after the combination treatment (P = 0.03). Subgroup analysis revealed that a significant decrease in ALT was observed only in patients with a baseline ALT ≥30 IU/L after the combination treatment (P = 0.005). Improvement of the FIB-4 index category was observed in patients in the baseline FIB-4 index ≥2.6 group and in the 1.3 ≤FIB-4 index <2.6 group (46% and 19%, respectively). The matched model showed no significant differences in liver function after combination treatment between the SGLT2i- and GLP1Ra-preceding groups.

conclusionsSGLT2i + GLP1Ra combination treatment significantly improved liver dysfunction and prevented the progression of FIB-4 index category among patients with an FIB-4 index ≥1.3.

Indexed as

Diabetes Mellitus, Type 2Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsLiverSodium-Glucose Transporter 2 InhibitorsAgedDrug Therapy, CombinationFemaleFollow-Up StudiesHumansLiver Function TestsMaleMiddle AgedRetrospective StudiesGlucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsSodium-Glucose Transporter 2 InhibitorsFIB‐4 indexGLP‐1 receptor agonistSodium‐glucose cotransporter inhibitor

Identifiers

PMID40331745
PMCPMC12209503

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.