Type 2 Diabetes: SGLT2 Inhibitor May Help Treat NAFLD Early

The sodium-glucose cotransporter 2 (SGLT2) inhibitor empagliflozin can help reduce liver fat content and could potentially help treat nonalcoholic fatty liver disease early among patients with recent-onset and metabolically well-controlled type 2 diabetes, according to new findings.

Researchers arrived at their conclusion after performing a recent randomized, double-blind, phase 4, placebo-controlled trial of 84 participants with type 2 diabetes. Participants were randomly assigned to receive 25 mg daily empagliflozin or placebo for 24 weeks.

The primary endpoint was defined as the between-group difference of the change in liver fat content, which was measured using magnetic resonance methods, from baseline to 24 weeks.

The results of the study indicated that treatment with empagliflozin had resulted in a placebo-corrected absolute change of −1.8% and relative change of −22% in liver fat content from baseline to the end of treatment, which corresponded to a 2.3-fold greater reduction.

The researchers observed weight loss among patients treated with empagliflozin (placebo-corrected change −2.5 kg), but they did not observe any placebo-corrected change in tissue-specific insulin sensitivity.

Empagliflozin use also led to placebo-corrected changes in uric acid (−74 mol/L) and high-molecular-weight adiponectin (36%) levels from baseline to 24 weeks, the researchers noted.

As a result of these findings, the researchers concluded that treatment with empagliflozin “could therefore contribute to the early treatment of nonalcoholic fatty liver disease in [type 2 diabetes].”

—Christina Vogt

Reference:
Kahl S, Gancheva S, Straßburger K, et al. Empagliflozin effectively lowers liver fat content in well-controlled type 2 diabetes: a randomized, double-blind, phase 4, placebo-controlled trial. Diabetes Care. 2020;43(2):298-305. https://doi.org/10.2337/dc19-0641.