Table 1.
Proven and possible effects of glucagon-like peptide-1 receptor agonists and sodium–glucose cotransporter 2 inhibitors in diabetes and metabolism-associated fatty liver disease before and after liver transplantation
| Therapy effect | NAFLD | T2DM | PTDM | Post-LT liver disease |
| GLP-1RA proven | Improvement in liver enzymes and intrahepatic triglycerides content[113-116,130,131] | Improvement of glycemia; increase insulin secretion in a glucose-dependent manner; inhibit glucagon secretion; weight loosing effect; cardiovascular protection[103-106] | Improvement of insulin and normalization of glucagon concentrations[150] | None metabolized by liver, no dose adjustments needed[156] |
| Resistance against toxicity of IS drugs in vitro[154] | ||||
| Weight loss during first weeks after LT[158] | ||||
| Improvements in weight, body mass index, glycemic control, liver enzymes, hsCRP[117] | ||||
| Prevention of steroid diabetes[155] | ||||
| Improvement in liver histology[118-120] | ||||
| Resolution of NASH[122,127-129] | ||||
| GLP-1RA possible | Reduction of hepatic steatosis; anti-inflammatory effect[107-112] | Improvement of cardiovascular outcomes[103-106], GI side effects potentiating GI disturbances caused by IS drugs[157] | ||
| SGLT-2i proven | Reduction of liver enzymes[65,135-142] | Improvement of glycemia; weight loosing effect; decrease in systolic and diastolic blood pressures; cardiovascular benefit[132-134] | Reduction of weight and blood pressure[162] | |
| Improved glycemia[163] | ||||
| Reduction of body weight and body fat[143-147] | ||||
| SGLT2i possible | Reduction of oxydative stress and inflammation[143-147] | Genitourinary infections[164] | Reduction in fat mass and visceral adipose tissue[165] |
GLP-1RA: Glucagon-like peptide-1 receptor agonists; IS: Immunosuppressive; LT: Liver transplant; NAFLD: Non-alcoholic fatty liver disease; T2DM: Type 2 diabetes mellitus; PTDM: Post-transplant diabetes mellitus; SGLT2i: Sodium-glucose cotransporter 2 inhibitors.