Glucagon-Like Peptide 1 Receptor Agonists and Sodium–Glucose Cotransporter 2 Inhibitors and Risk of Nonalcoholic Fatty Liver Disease Among Patients With Type 2 Diabetes

GLP-1 receptor agonists (GLP-1 RA) are associated with an incidence of 3.9 per 1,000 person-years for nonalcoholic fatty liver disease (NAFLD).

• SGLT-2 inhibitors are associated with a lower incidence of NAFLD at 5.4 per 1,000 person-years compared to DPP-4 inhibitors.
• The hazard ratio for NAFLD with SGLT-2 inhibitors is 0.78, suggesting a potentially reduced risk compared to DPP-4 inhibitors.
• GLP-1 RA show a hazard ratio of 0.86 for NAFLD, indicating a possibly lower risk than DPP-4 inhibitors, though the confidence interval is wide.
• Both GLP-1 RA and SGLT-2 inhibitors are associated with a decreased risk of liver enzyme elevation in specific subcohorts.
• The hazard ratios for liver enzyme elevation are 0.89 for GLP-1 RA and 0.66 for SGLT-2 inhibitors, demonstrating potential protective effects.

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