{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T19:55:46Z","timestamp":1792007746484,"version":"4.4.0"},"reference-count":35,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,1,18]],"date-time":"2020-01-18T00:00:00Z","timestamp":1579305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Astellas Pharma Korea, Inc.","award":["Astellas123"],"award-info":[{"award-number":["Astellas123"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Despite the benefits of pioglitazone in the treatment of non-alcoholic fatty liver disease (NAFLD), many treated patients continue to experience disease progression. We aimed to investigate the additive effect of ipragliflozin on NAFLD in patients with type 2 diabetes treated with metformin and pioglitazone. In this 24-week randomized controlled trial, 44 patients with type 2 diabetes and comorbid NAFLD were either randomized to receive 50 mg\/day of ipragliflozin as an add-on treatment (n = 29) or maintained on metformin and pioglitazone (n = 15). The fatty burden was assessed using the fatty liver index, NAFLD liver fat score, and controlled attenuation parameter (CAP). Changes in fat and muscle depots were measured by dual-energy x-ray absorptiometry and abdominal computed tomography scans. The enrolled patients were relatively controlled (mean baseline glycated hemoglobin of 6.6% \u00b1 0.6%) and centrally obese (mean waist circumference of 101.6 \u00b1 10.9 cm). At week 24, patients in the ipragliflozin add-on group exhibited reduced hepatic fat content (fatty liver index: \u22129.8 \u00b1 1.9, p = 0.002; NAFLD liver fat score: \u22120.5 \u00b1 0.2, p = 0.049; CAP: \u22128.2 \u00b1 7.8 dB\/m2, p = 0.133). Ipragliflozin add-on therapy also reduced whole-body visceral fat and the ratio of visceral to subcutaneous fat (change in whole-body visceral fat: \u221269.6 \u00b1 21.5 g; change in abdominal visceral fat: \u221226.2 \u00b1 3.7 cm2; abdominal visceral to subcutaneous fat ratio: \u22120.15 \u00b1 0.04; all p &lt; 0.05). In conclusion, ipragliflozin treatment significantly ameliorates liver steatosis and reduces excessive fat in euglycemic patients with type 2 diabetes and NAFLD taking metformin and pioglitazone.<\/jats:p>","DOI":"10.3390\/jcm9010259","type":"journal-article","created":{"date-parts":[[2020,1,21]],"date-time":"2020-01-21T03:04:43Z","timestamp":1579575883000},"page":"259","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["Ipragliflozin Additively Ameliorates Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Controlled with Metformin and Pioglitazone: A 24-Week Randomized Controlled Trial"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3237-3317","authenticated-orcid":false,"given":"Eugene","family":"Han","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Keimyung University School of Medicine, Daegu 42601, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea"},{"name":"Institue of Endocrine Research, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9899-4992","authenticated-orcid":false,"given":"Byung-Wan","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea"},{"name":"Institue of Endocrine Research, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Seok","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea"},{"name":"Institue of Endocrine Research, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bong-Soo","family":"Cha","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 03722, Korea"},{"name":"Institue of Endocrine Research, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1038\/nrgastro.2016.147","article-title":"NAFLD and diabetes mellitus","volume":"14","author":"Tilg","year":"2017","journal-title":"Nat. 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