ArticleJournal of the Endocrine Society2025
SGLT2 Inhibitors Modify Fibrosis-4 Index and Mitigate the Development of DKD: Role of Background Antidiabetic Drugs.
Article in Journal of the Endocrine Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Elevated FIB-4 index as a risk marker within the KDIGO framework in patients with type 2 diabetes and hypertension.BMJ open diabetes research & care · 2026Article
- SGLT2 Inhibitors Modify Fibrosis-4 Index and Mitigate the Development of DKD: Role of Background Antidiabetic Drugs.Journal of the Endocrine Society · 2025Article
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Authors and funding
13 authors.
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Abstract
Context: The fibrosis-4 (FIB-4) index is a noninvasive marker for liver fibrosis and is associated with the occurrence of diabetic kidney disease (DKD). Although sodium-glucose cotransporter-2 inhibitors (SGLT2is) are recognized to provide cardiovascular and renal benefits, the role of SGLT2is in regulating FIB-4 index and the subsequent effect on renal events remain unclear. Objective: This work aimed to clarify whether the FIB-4 index was associated with the development of DKD (estimated glomerular filtration rate < 60 mL/min/1.73 m Methods: A retrospective cohort study was conducted that included 136 patients with type 2 diabetes mellitus who were newly given SGLT2is for 3 years. Results: Patients with a high FIB-4 index (≥1.3) at baseline exhibited a higher incidence of de novo DKD, compared to those with a lower FIB-4 index (<1.3). This association was ameliorated in patients whose FIB-4 index was decreased during the SGLT2i treatment. Finally, among the background therapies, metformin use was associated with a decrease in FIB-4 index and a lower cumulative incidence of de novo DKD. Conclusion: Elevated FIB-4 index at baseline is a potent predictor for developing DKD, and combination therapy with SGLT2is and metformin may enhance renal protection by modulating FIB-4 index.
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