The effect of empagliflozin on non-alcoholic fatty liver disease-related parameters in patients with type 2 diabetes mellitus: a randomized controlled trial.

IF 2.8 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Fatemeh Shojaei, Azam Erfanifar, Saeid Kalbasi, Shahriar Nikpour, Latif Gachkar
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引用次数: 0

Abstract

Background and objective: The effects of Empagliflozin on liver health in patients with Type 2 Diabetes Mellitus (T2DM) have not been fully elucidated. This study aimed to assess the impact of Empagliflozin on liver steatosis and related biomarkers in T2DM patients.

Methods: A before-after clinical trial was conducted with 119 T2DM patients aged 20 to 70 with fatty liver, recruited from Laghman Hakim Hospital, Tehran, Iran. Participants were administered Empagliflozin for 6 months, with clinical and laboratory assessments conducted at baseline, 3 months, and 6 months. Liver function was evaluated through blood tests and imaging, including ultrasound and Magnetic resonance imaging (MRI), to assess hepatic steatosis. Biomarkers such as HbA1c, fasting blood glucose, insulin, lipid profile, and liver enzymes were measured. Insulin resistance was estimated using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) formula. Data were analyzed using SPSS 26 and STATA 14.

Results: A total of 119 patients (Intervention (N = 69), Control (N = 50)) were participated. The intervention group demonstrated a significant reduction in liver fat grade compared to the control group, with 17.5% of patients showing a reduction from grade 3 to grade 1 on MRI and 6% in the control group. The odds of worsening fatty liver in the control group were 48 times higher (95% CI: 15.5, 148.5) on MRI and 52 times higher (95% CI: 15.2, 178.1) on ultrasound, compared to the intervention group (NNT = 2). After 6 months, the intervention group showed significantly lower risks for ALT (RR: 0.72, 95% CI: 0.62-0.84), AST, and alkaline phosphatase (Alkp) abnormalities. Liver enzyme levels (ALT, AST, GGT) and systolic blood pressure (SBP) decreased significantly in the Empagliflozin group, with mean differences of -15.33 (95% CI: -18.8, -11.88) for ALT, -12.82 (95% CI: -15.5, -10.13) for AST, and - 6.31 (95% CI: -8.65, -3.97) for systolic blood pressure (SBP).

Conclusion: These findings suggest that Empagliflozin could be an effective adjunctive therapy for managing liver dysfunction in T2DM patients with NAFLD.

Trial registration: Registered retrospectively in the Iranian Registry of Clinical Trials (IRCT20210811052150N1) on April 16,2023 Access at https://irct.behdasht.gov.ir/search/result?query=IRCT20210811052150N1 .

背景和目的:恩格列净对2型糖尿病(T2DM)患者肝脏健康的影响尚未完全阐明。本研究旨在评估 Empagliflozin 对 T2DM 患者肝脏脂肪变性及相关生物标志物的影响:从伊朗德黑兰的拉格曼-哈基姆医院招募了 119 名年龄在 20 岁至 70 岁之间的 T2DM 脂肪肝患者,对其进行了前后对比临床试验。参与者接受了为期 6 个月的 Empagliflozin 治疗,并在基线、3 个月和 6 个月时进行了临床和实验室评估。通过血液化验和成像(包括超声波和磁共振成像(MRI))评估肝脏功能,以评估肝脏脂肪变性。还测量了 HbA1c、空腹血糖、胰岛素、血脂概况和肝酶等生物标志物。胰岛素抵抗采用胰岛素抵抗稳态模型评估(HOMA-IR)公式进行估算。数据使用 SPSS 26 和 STATA 14 进行分析:共有 119 名患者(干预组(69 人)和对照组(50 人))参与了研究。与对照组相比,干预组患者的肝脏脂肪等级明显降低,17.5% 的患者在核磁共振成像中的肝脏脂肪等级从 3 级降至 1 级,而对照组仅为 6%。与干预组相比,对照组脂肪肝恶化的几率在核磁共振成像上是干预组的48倍(95% CI:15.5, 148.5),在超声波上是干预组的52倍(95% CI:15.2, 178.1)(NNT = 2)。6 个月后,干预组出现 ALT(RR:0.72,95% CI:0.62-0.84)、AST 和碱性磷酸酶(Alkp)异常的风险明显降低。Empagliflozin组的肝酶水平(ALT、AST、GGT)和收缩压(SBP)显著下降,ALT的平均差异为-15.33(95% CI:-18.8,-11.88),AST的平均差异为-12.82(95% CI:-15.5,-10.13),收缩压(SBP)的平均差异为-6.31(95% CI:-8.65,-3.97):这些研究结果表明,Empagliflozin可作为一种有效的辅助疗法,用于治疗患有非酒精性脂肪肝的T2DM患者的肝功能异常:于2023年4月16日在伊朗临床试验注册中心进行了回顾性注册(IRCT20210811052150N1),访问网址:https://irct.behdasht.gov.ir/search/result?query=IRCT20210811052150N1 。
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来源期刊
BMC Endocrine Disorders
BMC Endocrine Disorders ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
280
审稿时长
>12 weeks
期刊介绍: BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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