Mymensingh Medical College
  • Mymensingh, Bangladesh
Recent publications
OBJECTIVE To use molecular techniques to assess the prevalence of M. bovis and M. tuberculosis in tuberculin-positive dairy cattle and to identify the risk factors for TB in these animals. METHODS A cross-sectional study was conducted from 2018 to 2020 across Mymensingh, Sirajgonj and Dhaka Districts in Bangladesh. The single intradermal comparative cervical tuberculin test was administered to 1,580 cattle suspected of having bovine TB using both avian and bovine purified protein derivative. Milk and lung tissue samples from positive animals were examined using polymerase chain reaction (PCR) to detect the causative agents of TB. Multivariable logistic regression model identified risk factors, and Sanger's dideoxy sequencing method was used for the phylogenetic analysis of PCR amplicons. RESULTS Simplex PCR identified Mycobacterium tuberculosis complex in 12.6% of samples. Multiplex PCR detected M. bovis in 6.3% and M. tuberculosis in 3.1% of the samples. Phylogenetic analysis of 12 IS6110 gene sequences (8 M. bovis, 4 M. tuberculosis) confirmed alignment with human isolates from Bangladesh. CONCLUSION The study suggests potential reverse zoonotic transmission of M. tuberculosis. Further research is needed to understand the implications and assess TB transmission between humans and cattle in Bangladesh. The findings highlight the need for a comprehensive One Health approach. .
Background The World Health Organization (WHO) recommended cryptococcal antigen (CrAg) screening for people presenting with advanced HIV disease (AHD) and for those with positive CrAg without evidence of meningitis to initiate preemptive antifungal medication. Data on the implementation of WHO recommendations regarding CrAg screening is limited. We estimated pooled prevalence of CrAg screening uptake, cryptococcal antigenemia, lumbar puncture, cryptococcal meningitis and initiation of preemptive antifungal medication from available eligible published studies conducted in Africa. Methods PubMed, Cochrane Library and Embase were searched for articles published between January 2011 and December 2023. CrAg uptake was defined as percentage of eligible people (CD4 ≤ 200 cells/mm³ or WHO stage III/IV) who received cryptococcal antigen testing. Stratified analysis to compare uptake and cryptococcal antigenemia between studies that involved multiple vs single sites was performed. Using random effects models, we computed the pooled estimate of CrAg screening uptake, cryptococcal antigenemia, lumbar puncture, cryptococcal meningitis, preemptive antifungals treatment and 95% confidence intervals (CIs). Results Ten studies with 18,820 individuals with AHD were analyzed. Overall, the pooled estimate of CrAg screening uptake was 57.1% (95% CI: 41.4–72.7). CrAg screening uptake was significantly lower among studies that involved multiple sites compared to those that involved single site, (47.3% vs 73.3%; p<0.001). Overall, the pooled prevalence of cryptococcal antigenemia was 9.6% (95% CI:6.4–12.9). Cryptococcal antigenemia was significantly lower among studies that involved multiple sites compared to those that involved single site, (9.1% vs 10.4%; p<0.001). Among those who tested positive for CrAg, 84.6% (95% CI: 54.1–99.0) received preemptive antifungal treatment, though nearly 25% did not undergo lumbar puncture, highlighting gaps in diagnostic follow-up. Six studies evaluated CrAg positive patients with lumbar puncture and the overall prevalence of lumbar puncture was 74.9% (48.0–94.8). The overall prevalence of cryptococcal meningitis was 58.1% (46.6–69.6). Conclusions Not screening for CrAg among people with AHD and failure to initiate antifungal medications among eligible patients with cryptococcal antigenemia presents a significant missed opportunity. Emphasis on improving CrAg screening is critical given its proven cost-effective benefits.
Purpose of Review Hypertension remains a major chronic disease morbidity across the world, even in the twenty-first century, affecting ≈40% of the global population, adversely impacting the healthcare budgets in managing the high incidence of cardiovascular disease (CVD) complications and mortality because of elevated blood pressure (BP). However, evaluation and management of endocrine hypertension are not optimal in clinical practice. With three unique clinical case scenarios, we update the evidence base for diagnostic evaluation and management of endocrine hypertension in this review to inform appropriate day-to-day clinical practice decisions. Recent Findings Although most individuals with high BP suffer from essential hypertension (≈85%), some patients may have a clear underlying etiology (termed secondary hypertension), and a significant proportion of these patients have endocrine hypertension (≈10%) consequent to hormone excess from dysfunction of one or more endocrine glands. Even if a relatively common disease in the general population, the correct diagnosis and appropriate treatment of endocrine hypertension is often delayed because of poor awareness among clinicians, including primary care providers and physicians in the secondary care settings. Summary An accurate and timely diagnosis of endocrine hypertension is crucial to potentially cure or at least properly manage these patients because the consequences of delays in diagnosis can be catastrophic, with markedly higher end-organ complications such as CVD, chronic kidney disease, and even premature mortality among sufferers.
Background: Data on the carcinogenic potential of tirzepatide from randomized controlled trials (RCTs) are limited. Furthermore, no meta-analysis has included all relevant RCTs to assess the cancer risk associated with tirzepatide. Methods: RCTs involving patients receiving tirzepatide in the intervention arm and either a placebo or any active comparator in the control arm were searched through electronic databases. The primary outcome was the overall risk of any cancer, and secondary outcomes were the risks of specific types of cancer in the tirzepatide versus the control groups. Results: Thirteen RCTs with 13,761 participants were analyzed. Over 26 to 72 weeks, the tirzepatide and pooled control groups had identical risks of any cancer (risk ratio, 0.78; 95% confidence interval, 0.53 to 1.16; P=0.22). The two groups had comparable cancer risks in patients with and without diabetes. In subgroup analyses, the risks were also similar in the tirzepatide versus placebo, insulin, and glucagon-like peptide-1 receptor agonist groups. The overall cancer risk was also comparable for different doses of tirzepatide compared to the control groups; only a 10-mg tirzepatide dose had a lower risk of any cancer than placebo. Furthermore, compared to the control groups (pooled or separately), tirzepatide did not increase the risk of any specific cancer types. Despite greater increments in serum calcitonin with 10- and 15-mg tirzepatide doses than with placebo, the included RCTs reported no cases of papillary thyroid carcinoma. Conclusion: Tirzepatide use in RCTs over 26 to 72 weeks did not increase overall or specific cancer risk.
Objectives To determine the prevalence of self‐reported delayed adverse events (DAEs), major AEs, and flares following COVID‐19 vaccinations among patients with autoimmune rheumatic diseases (AIRDs) in Malaysia. Methodology An electronically validated survey from the COVID‐19 vaccination in autoimmune diseases (COVAD) study group was distributed in July 2021 to patients with autoimmune diseases and healthy controls (HCs). The survey collected data on DAEs (any AE that persisted or occurred after 7 days of vaccination), any early or delayed major adverse events (MAEs), and flares following COVID‐19 vaccination. Generalized estimating equation (GEE) models were performed to determine the factors associated with repeated events of DAEs, MAEs, and flares. Results A total of 556 vaccines were administered to 204 subjects (150 AIRDs and 54 HCs), with 72.1% completing 3 doses. In multivariate GEE analysis, there was a greater frequency of minor DAEs among AIRDs versus HCs (OR 5.65, p = 0.052). The occurrence of MAEs was higher in AIRDs versus HCs (4.9% vs. 1.3%, p = 0.052), but it was no longer significant in the GEE model. In the AIRDs group, the BNT162b2 vaccine increased the risk for minor DAEs (OR4.68, p = 0.02) while patients with autoimmune multimorbidity showed a greater risk for MAEs (OR 8.25, p = 0.007). The rate of flare was 10.6% and multivariate GEE analysis revealed that The rate of flare was 10.6% and multivariate GEE analysis revealed that systemic lupus erythematosus (SLE) (OR0.31, p = 0.03) and hydroxychloroquine (HCQ) (OR 0.16, p < 0.001) were protective against flare. Conclusion The rates of minor DAEs, major AEs, and flares were comparable with other reported studies. Different types of vaccines, underlying AIRDs, and treatments may influence the symptoms of AEs and flares postvaccination against COVID‐19.
Background: Influenza remains a significant public health challenge in low- and middle-income countries (LMICs) like Bangladesh, where vaccine uptake remains low despite the substantial disease burden. Physicians play a vital role in promoting vaccination, yet their intentions and influencing factors are not well understood. Methods: We conducted a cross-sectional study from June to October 2022 across four tertiary-level hospitals in Bangladesh using a questionnaire grounded in the Theory of Planned Behavior (TPB). Hierarchical logistic regression was employed to identify factors associated with vaccine recommendation intentions. Results: Among 972 physicians with an average age of 32.1 years, 40.1% intended to recommend and administer the influenza vaccine. Most (85.3%) agreed vaccination reduces risk, 65.5% desired vaccination for self-protection, 63.5% would vaccinate if available at work, and 85.3% anticipated Ministry of Health support. Male (OR = 1.9, 95% CI: 1.5–2.3) and married (OR = 1.5, 95% CI: 1.1–1.9) physicians were more likely to recommend vaccination. Each unit increase in attitude score doubled the likelihood of recommending the vaccine (OR = 2.0, 95% CI: 1.4–3.0). Conclusions: Physicians’ influenza vaccine recommendations in Bangladesh are suboptimal, influenced by gender, marital status, and attitudes. Targeted educational interventions addressing attitudinal barriers and leveraging institutional support could improve recommendation practices.
Objectives Physical function in RA is largely influenced by multiple clinical factors; however, there is a growing body of evidence that psychological state and other comorbidities also play an essential role. Using data obtained in the COVAD study, an international self-reported e-survey, we aimed to a) explore the predictive ability of sociodemographic and clinical variables on PROMIS physical function short form-10a (PROMIS PF-10a) in RA and b) to investigate variation in disease activity and functional outcomes based on country-level socio-economic parameters. Methods Patient demographics, disease characteristics including current symptom status, functional status and treatment variables as well as income level of the country of residence, were extracted from survey responses. PROMIS PF-10a scores were compared across country income levels. The influence of extracted variables on reversed PROMIS PF-10a scores were investigated using negative binomial univariable- and multi-variable regression. Results A total of 1,342 RA patients were included in this analysis. In the optimised parsimonious predictive model for reversed PROMIS PF-10a, older age, female gender, disease duration, fatigue and pain levels were independently associated with worse physical function, whereas Asian ethnicity, higher overall physical health ratings, ability to carry out everyday activities, and residing in a country with an upper-middle or high-income level were independently associated with better physical function. Conclusion Our study highlights that clinical factors remain strong predictors of physical function in RA, irrespective of individual and country-level socioeconomic differences. Interestingly, high country-level income was associated with better physical function, irrespective of individual sociodemographic and clinical factors.
Objectives To predict and characterize the three-dimensional (3D) structure of protein arginine methyltransferase 2 (PRMT2) using homology modeling, besides, the identification of potent inhibitors for enhanced comprehension of the biological function of this protein arginine methyltransferase (PRMT) family protein in carcinogenesis. Materials and methods An in silico method was employed to predict and characterize the three-dimensional structure. The bulk of PRMTs in the PDB shares just a structurally conserved catalytic core domain. Consequently, it was determined that ligand compounds may be the source of co-crystallized complexes containing additional PRMTs. Possible PRMT2 inhibitor compounds are found by using S-adenosyl methionine (SAM), a methyl group donor, as a positive control. Results Protein arginine methyltransferases are associated with a range of physiological processes, including as splicing, proliferation, regulation of the cell cycle, differentiation, and signaling of DNA damage. These functional capacities are also related to carcinogenesis and metastasis-several forms of PRMT have been cited in the literature. These include PRMT-1, PRMT-2, and PRMT-5. Among these, the role of PRMT-2 has been shown in breast cancer and hepatocellular carcinoma. To gain more insights into the role of PRMT2 in cancer pathogenesis, we opted to characterize tertiary structure utilizing an in silico approach. The majority of PRMTs in the PDB have a structurally conserved catalytic core domain. Thus, ligand compounds were identified as a possible source of co-crystallized complexes of other PRMTs. The SAM, a methyl group donor, is used as a positive control in order to identify potential inhibitor compounds of PRMT2 by the virtual screening method. We hypothesized that an inhibitor for other PRMTs could alter PRMT2 activities. Out of 45 inhibitor compounds, we ultimately identified three potential inhibitor compounds based on the results of the pharmacokinetics and binding affinity studies. These compounds are identified as 3BQ (PubChem CID: 77620540), 6DX (PubChem CID: 124222721), and TDU (PubChem CID: 53346504). Their binding affinities are −8.5 kcal/mol, −8.1 kcal/mol, and −8.8 kcal/mol, respectively. These compounds will be further investigated to determine the binding stability and compactness using molecular dynamics simulations on a 100 ns time scale. In vitro and in vivo studies may be conducted with these three compounds, and we think that focusing on them might lead to the creation of a PRMT2 inhibitor. Conclusion Three strong inhibitory compounds that were non-carcinogenic also have drug-like properties. By using desirable parameters in root mean square deviation (RMSD), root mean square fluctuation (RMSF), radius of gyration (Rg), solvent accessible surface area (SASA), molecular surface area (MolSA), and intermolecular hydrogen bonding, complexes verified structural stability and compactness over the 100 ns time frame. How to cite this article Hossen MS, Islam MN, Pramanik MEA et al. Molecular Characterization and Potential Inhibitors Prediction of Protein Arginine Methyltransferase-2 (PRMT2) in Carcinoma: An Insight from Molecular Docking, ADMET Profiling and Molecular Dynamics Simulation Studies. Euroasian J Hepato-Gastroenterol 2024;14(2):160–171.
Background Endogenous glucagon‐like peptide‐1 (GLP‐1) and glucose‐dependent insulinotropic polypeptide (GIP) regulate islet cell function. GLP‐1 receptor agonists (GLP‐1RAs) have been associated with an elevated risk of acute pancreatitis. Data on the pancreatic safety of tirzepatide (a dual GLP‐1 and GIP agonist) and its effects on islet cell function in randomized controlled trials (RCTs) are scarce. Moreover, no meta‐analysis has comprehensively examined such effects of tirzepatide. Methods Electronic databases were searched for RCTs with tirzepatide as the intervention and a placebo or active comparator as the control. The primary outcome was adjudication‐confirmed pancreatitis; secondary outcomes were the percent changes from baseline in serum pancreatic amylase, lipase, insulin, C‐peptide, glucagon, and homeostasis model assessment of insulin resistance (HOMA2‐IR). Results Seventeen RCTs with 18 published reports involving 14,645 subjects were analyzed. Over a follow‐up duration of 12–72 weeks, tirzepatide had identical risks of pancreatitis to placebo (tirzepatide 5 mg: RR 2.04, 95% CI [0.27–15.69], p = 0.49; 10 mg: RR 0.63, 95% CI [0.08–5.12], p = 0.67; and 15 mg: RR 1.26, 95% CI [0.36–4.98], p = 0.72). Tirzepatide was also associated with comparable risks of pancreatitis to insulin and GLP‐1RAs. However, tirzepatide (at all doses) caused greater increases in pancreatic amylase and lipase than placebo and insulin. Individuals on tirzepatide 15 mg and GLP‐1RAs had similar risks of having increased lipase levels. The percent reductions in fasting insulin were greater with tirzepatide 10 and 15 mg than with placebo. All doses of tirzepatide caused greater percent reductions in fasting insulin, C‐peptide, and glucagon than GLP‐1RAs. Compared to placebo and GLP‐1RAs, the percent reductions in HOMA2‐IR were greater with all doses of tirzepatide. Conclusion The meta‐analysis provides evidence of the safety of tirzepatide regarding pancreatitis and establishes its positive effect on islet cell functions and insulin resistance.
Purpose: Early gestational diabetes mellitus (eGDM) refers to elevated blood glucose levels not meeting the criteria for overt diabetes before 20 weeks gestation. Observational studies link eGDM to adverse outcomes, but randomized controlled trial (RCT) evidence on early intervention benefits remains inconclusive. To address this, we performed a systematic review and meta-analysis (SRM) of RCTs on this subject. Methods: We searched electronic databases to identify RCTs comparing early treatment versus observation for eGDM. The primary neonatal outcomes analyzed were large-for-gestational-age (LGA) and macrosomia. The primary maternal outcome was pregnancy-related hypertension. Secondary neonatal outcomes included neonatal respiratory distress (NRD), neonatal intensive-care unit (NICU) admission, small-for-gestational-age (SGA), cord-blood C-peptide ≥90th percentile, and neonatal hypoglycemia. Secondary maternal outcomes were cesarean section (CS), emergency CS, labor induction, preeclampsia, and preterm birth. Results: Seven RCTs involving 4,427 pregnancies were analyzed. The studies differed in their timing and methods of inclusion. Six studies used a combination of lifestyle and pharmaceutical interventions, while one relied solely on lifestyle modifications. Early treatment did not reduce LGA [OR 0.84 (95%CI: 0.53–1.32); P=0.44], macrosomia [OR 0.68 (95%CI: 0.43–1.06); P=0.09], or pregnancy-related hypertension [OR 1.04 (95%CI: 0.68–1.57); P=0.87]. Among the secondary outcomes, only NRD was significantly reduced in the treatment arm [OR 0.52 (95%CI: 0.34–0.80); P=0.003]. However, sensitivity analysis, omitting the lifestyle-only study, demonstrated a lower risk of macrosomia with early intervention [OR 0.55 (95%CI: 0.34–0.91); P=0.02]. Conclusion: The SRM demonstrates early intervention does not improve most pregnancy outcomes, except NRD. Sensitivity analysis, excluding the lifestyle-only study, additionally revealed a reduction in macrosomia. The findings must be interpreted cautiously due to the variability in study designs. Replication in well-designed multicenter trials is required before clinical application.
The glucagon receptor antagonist (GRA) volagidemab is the first‐in‐class fully human monoclonal antibody that inhibits glucagon receptor. GRA can improve glycemia by reducing endogenous glucose production and reduce risks of diabetic ketoacidosis by suppressing ketogenesis. This systematic review and meta‐analysis analyzed the efficacy and safety of volagidemab in type‐1 diabetes (T1D). Electronic databases were searched for randomized controlled trials (RCTs) involving T1D patients receiving volagidemab. The primary outcome was to evaluate changes in total daily dose (TDD) of insulin. The secondary outcomes were to evaluate changes in measures of glycemia, hypoglycemia, and adverse events. Data from 3 RCTs (98 patients) were analyzed. Volagidemab (70 mg/week) was associated with a significant reduction in TDD of insulin requirement (mean difference [MD]: −8.45 units/day (95% confidence interval [CI]: [−12.09, −4.81]); I² = 83%; p < 0.01) and average blood glucose (MD: −21.42 mg/dL (95% CI: [−37.10, −5.74]); I² = 88%; p < 0.01), compared to placebo. Volagidemab use was associated with a significant increase in time in range (blood glucose: 70–180 mg/dL) (MD: 10.93% (95% CI: [6.69, 15.17]); I² = 55%; p < 0.01) and significant reduction in time above range (blood glucose >180 mg/dL) (MD: −11.93% (95% CI: [−14.71, −9.15]); I² = 6%; p < 0.01) without any impact on time below range (blood glucose <70 mg/dL) (MD: 0.14% (95% CI: [−0.56, 0.84]); I² = 0%; p = 0.70), compared to placebo. Occurrence of treatment‐emergent adverse events (odds ratio [OR]: 0.96 (95% CI: [0.36, 2.56]); I² = 8%; p = 0.94) and hypoglycemia (OR: 0.56 (95% CI: [0.11, 2.89]); I² = 0%; p = 0.49) were similar among volagidemab users as compared to placebo. Short‐term volagidemab use was associated with significant reduction in insulin requirement along with improvement in glycemia.
Nowadays, heart disease is a serious medical issue, and diagnosis is crucial to providing the proper treatment to the patient. Hence, machine learning (ML)-based early diagnosis of heart disease can reduce time and misdiagnosis. In this paper, we examine the various machine learning models for detecting heart diseases early and propose a method of optimized logistic regression (OLR) to make predictions more accurate. The proposed model uses GridSearchCV and five-fold crossvalidation to determine the best parameter for the logistic regression (LR) classifier and tune the hyperparameter. For evaluations, we conducted extensive experiments and compared the proposed method with different machine learning methods including Logistic Regression (LR), Support Vector Machine (SVM), Random Forest (RF), AdaBoost (AB), and Naive Bayes (NB). The results confirmed that the proposed method improved overall performance with an accuracy of 90.74% and area under the curve (AUC) of 0.95
Fahr's disease, also known as primary familial brain calcification, is a progressive neurological disorder that follows an autosomal dominant inheritance pattern, characterized by calcifications primarily located within the basal ganglia of the brain. This condition typically affects middle-aged individuals, who present with a combination of neurological and psychiatric symptoms; however, this case report discusses a 16-year-old male patient. The patient initially exhibited general signs of infection, including fever and jaundice, before developing specific neurological symptoms, which progressed to systemic encephalopathy characterized by altered consciousness, seizures, and hypoglycemia, necessitating his admission to the ICU. Tragically, despite receiving intensive medical treatment, the patient succumbed to the disease, highlighting the challenges associated with diagnosing and managing Fahr's disease, particularly in younger patients.
Background This study aimed to characterise the clinical and epidemiological profiles of dengue patients and their outcomes during an ongoing outbreak in a non-endemic region of Bangladesh. Methods This prospective observational study analysed 805 confirmed dengue cases during August–December 2023. Data on demographic, clinical and laboratory profiles, as well as outcomes, were gathered using a structured questionnaire. Statistical analysis was conducted using SPSS 25. Results The mean age of dengue patients was 31.5 (±12.2) y, with the majority being males (81.2%). All 805 patients experienced fever, 792 (98.4%) had headaches, 698 (86.7%) had myalgia, 601 (74.7%) had persistent vomiting and 598 (74.3%) had abdominal pain. Bleeding was observed in 191 (23.7%) patients and neurological symptoms were seen in 209 (25.9%) patients. Most patients (n=781, 97%) exhibited non-severe symptoms, while 3% (n=24) had severe symptoms. Among the 24 severe cases, four (16.7%) patients were reported to have encephalitis and one (4.2%) patient had meningoencephalitis. Moreover, 365 patients (45.3%) had travelled to an endemic region who were predominantly males (n=327, 89.6%). Most dengue patients recovered well with rapid fluid replacement therapy (n=754, 93.7%). Conclusions The 2023 dengue outbreak in a non-endemic area of Bangladesh primarily impacted males, young adults, with the majority presenting non-severe symptoms. Further studies are essential to validate and build upon these results.
Marked alterations in the normal female hormonal milieu in the perimenopausal period significantly affect women’s health, leading to decreased well-being, psychological distress, and impaired quality of life. Common menopausal symptoms include hot flashes, sleep and mood changes, fatigue, weight gain, and urogenital disturbances. Clinicians often neglect mood swings and disrupted sleep, although those can significantly limit the productivity of women and impair their cognitive function and mental health. Evidence-based management should include a personalized, holistic approach to alleviate symptoms and careful consideration of the risks vs benefits of hormone replacement therapy (HRT), with due consideration of personal preferences. A research paper in the recent issue of the World Journal of Psychiatry by Liu et al investigated the role of HRT in altering mood changes and impaired sleep quality in menopausal women, which helps us to understand the benefits of this treatment approach.
Background: Obeticholic acid (OCA) has emerged as a promising drug in the management of nonalcoholic fatty liver disease (NAFLD). This meta-analysis aimed to analyse the therapeutic effect of OCA on NAFLD. Methods: Randomized controlled trials (RCTs) involving patients with NAFLD receiving OCA in the intervention arm and placebo in the control arm were searched throughout the electronic databases. The primary outcomes were changes in non-invasive markers of hepatic fibrosis and liver histology. The secondary outcomes included changes in liver enzymes, metabolic parameters from baseline and adverse events (AEs). Results: Four RCTs involving 1,278 subjects met the inclusion criteria. Over 6 weeks to 18 months of clinical use, OCA outperformed placebo in resolving definite nonalcoholic steatohepatitis (odds ratio [OR] 1.60, 95% confidence interval [CI] [1.04–2.48], p=0.03) and improving fibrosis (OR 2.23, 95% CI [1.56–3.20], p<0.0001), hepatocellular ballooning (OR 1.83, 95% CI [1.35–2.47], p<0.0001) and lobular inflammation (OR 1.62, 95% CI [1.13–2.32], p=0.009). OCA did not improve the enhanced liver fibrosis score and steatosis better than placebo, and demonstrated superior efficacy compared with the placebo in reducing serum alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase levels. Although a favourable effect of OCA over placebo was seen in body-weight reduction, the OCA use was associated with adverse changes in lipid parameters. Except for the greater risk of pruritus and constipation, the AE profile was comparable between the OCA and placebo groups. Conclusions: OCA has a favourable efficacy in improving liver histology and liver enzymes. However, the worsening of lipid parameters and other AEs with the OCA use warrants further investigation.
Aims: While randomized controlled trials data on the long‐term effect of glucose‐lowering drugs (GLDs) on liver‐related outcomes are lacking, population‐based studies have evaluated the associations of GLDs with liver‐related outcomes in individuals with type 2 diabetes (T2D). we aimed to conduct a systematic review of population‐based studies evaluating the effects of GLDs on liver‐related outcomes in people with T2D. Methods: PubMed, Web of Science, and Embase databases were systematically searched for population‐based studies testing the associations of GLDs with liver‐related outcomes in individuals with T2D and no liver disease other than non‐alcoholic fatty liver disease (NAFLD) from inception to 23 February 2024. GLDs included SGLT2is, TZDs, insulin, GLP‐1 RAs and dipeptidyl peptidase‐4 inhibitors (DPP4Is). Results: Ten cohort studies, comprising 1,274,641 participants, met the inclusion criteria. The median follow‐up period ranged from 8.9 to 76 months. Of all the GLDs under investigation, SGLT2is were associated with the strongest reduction in NAFLD incidence, cirrhosis, and composite liver‐related events compared to other medications. TZDs were associated with a reduced risk of developing NAFLD and cirrhosis but were not significantly associated with a lower incidence of hepatocellular carcinoma. GLP‐1 RAs demonstrated a significant association with reduced liver‐related mortality. Conclusions: Observational data from population‐based studies suggest that GLDs such as SGLT2is are associated with beneficial long‐term liver‐related outcomes in T2D patients with NAFLD. Additional studies, including randomized controlled trials with long‐term follow‐up, are needed to confirm these findings.
Institution pages aggregate content on ResearchGate related to an institution. The members listed on this page have self-identified as being affiliated with this institution. Publications listed on this page were identified by our algorithms as relating to this institution. This page was not created or approved by the institution. If you represent an institution and have questions about these pages or wish to report inaccurate content, you can contact us here.
72 members
Muhammad Akram Hossain
  • Department of Medicine
Proggananda Nath
  • Infectious and Tropical Medicine
Shiblee Sadeque Shakil
  • Department of Cardiology
A.B.M. Kamrul Hasan
  • Endocrinology
Information
Address
Mymensingh, Bangladesh