Endocrine Abstracts

Aim: Non-alcoholic fatty liver disease (NAFLD) is a common comorbidity with type 2 diabetes and a few agents such as pioglitazone and metformine has been shown to beneficial effects. SGLT-2 inhibitors are used in the treatment in type 2 diabetes (T2D). It has been shown that they can the effectivenes of improve liver function in patients with NAFLD as well as in T2D. In our study we aim to elucidate the effectiveness of SGLT-2 inhibitors as second line treatment for NAFLD patients with T2D by comparing with pioglitazone.

Patients and measurements: NAFLD patients with T2D (n=34) who did not use SGLT2 inhibitors (dapagliflozin, empagliflozin) or pioglitazone were enrolled in the current study. Patients were divided into 3 subgroup who were treated with Dapagliflozin 10 mg, empagliflozin 10 mg and pioglitazone 45 mg as a second line treatment of T2D. Before and after the treatment; all biochemical parameters of the patients’ were screened as well as the body mass index and waist circumference. Patients were also followed-up the same treatment during the 16 weeks. Screening for NAFLD was performed using MRI-based (3.0 T, Ingenia, Philips Medical Systems, Best, The Netherlands) proton density fat fraction before and after the treatment. All patients were matched in case of baseline body mass index (BMI), gender differences.

Results: At the end of the 16 weeks after the treatment HbA1c levels (%) of the patients treated with Dapagliflozin (P=0.04) and Empagliflozin (P=0.01) were decreased compared to baseline levels but not pioglitazone (P= 0.108). While changing of waist circumference of the patients treated with dapagliflozin (P=0.001) or empagliflozine (P=0.008) were statistically significant, patients with pioglitazone were not significant (P=0.801). Baseline hepatic steatosis measurements of the patients’ treated with Dapa, Empa and Pio were 0.19±0.09, 0.17±0.07 and 0.14±0.09, respectively. At the end of the study; measurements of patients’ were 0.11±0.09 (P=0.001), 0.13±0.08 (P=0.09) and 0.12±0.14 (P=0.360), respectively.

Conclusion: Dapagliflozin may have a beneficial modulatory effect on NAFLD as well as the T2D.