{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:28:08Z","timestamp":1791041288001,"version":"4.1.0"},"reference-count":78,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pemafibrate, a selective peroxisome proliferator-activated receptor \u03b1 modulator, ameliorates hypertriglyceridemia. We investigated the effects of pemafibrate on steatotic liver disease (SLD) in relation to various atherogenic lipid profiles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty-nine Japanese patients with both type 2 diabetes mellitus (T2DM) and hypertriglyceridemia (men\/women: 24\/15, mean age: 58.2 years, median duration of diabetes: 5.0 years) were treated with 0.2 mg\/day of pemafibrate for 12 months (M). SLD was estimated by fatty liver index (FLI), which is calculated by using waist circumference, body mass index and levels of triglycerides and \u03b3-glutamyl transpeptidase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Treatment with pemafibrate significantly increased mean levels of high-density lipoprotein cholesterol (HDL-C) (baseline\/3M\/6M\/12M: 46\/55\/55\/54 mg\/dL) and decreased median levels of triglycerides (baseline\/3M\/6M\/12M: 211\/112\/99\/98 mg\/dL), non-HDL-C (146\/128\/125\/121 mg\/dL), small dense low-density lipoprotein cholesterol (45\/33\/30\/30 mg\/dL) and remnant-like particle cholesterol (8.1\/2.6\/2.3\/2.4 mg\/dL). There was no significant change in hemoglobin A1c level over time. FLI (mean \u00b1 standard deviation: 68.1 \u00b1 21.9 <jats:italic>vs<\/jats:italic>. 39.6 \u00b1 25.0, P &amp;lt; 0.001), but not FIB-4 index as a marker of hepatic fibrosis (median [interquartile range]: 1.04 [0.78-1.39] <jats:italic>vs<\/jats:italic>. 1.01 [0.68-1.36], P = 0.909), was significantly decreased by treatment with pemafibrate for 12M, and the proportion of patients with metabolic dysfunction-associated SLD (MASLD) was significantly decreased from 92.3% (baseline) to 61.5% (12M).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pemafibrate ameliorates MASLD estimated by FLI in addition to various atherogenic lipid profiles in Japanese hypertriglyceridemia patients with T2DM in the past mean 5 years. An early intervention with pemafibrate might contribute to prevention of the development of MASLD and atherosclerotic cardiovascular disease.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1496671","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T04:10:25Z","timestamp":1752725425000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Treatment with pemafibrate ameliorates fatty liver index and atherogenic lipid profiles in Japanese patients with type 2 diabetes mellitus"],"prefix":"10.3389","volume":"16","author":[{"given":"Toru","family":"Suzuki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marenao","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Nakata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Endo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Aida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wataru","family":"Kawaharata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itaru","family":"Hosaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Araya","family":"Umetsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Ogawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukinori","family":"Akiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Furuhashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.03.009","article-title":"2019 ACC\/AHA guideline on the primary prevention of cardiovascular disease: executive summary: A report of the American college of cardiology\/American heart association task force on clinical practice guidelines","volume":"74","author":"Arnett","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx144","article-title":"Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. 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