Koullias Emmanouil, Papavdi Maria, Athanasopoulos Stavros, Mitrakou Asimina, Deutsch Melanie, Zoumpoulis Pavlos, Manesis Emmanuel, Thanopoulou Anastasia, Koskinas John
2nd Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens, Hippocration General Hospital, Athens, GRC.
2nd Department of Internal Medicine, Medical School, Hippocration General Hospital, National and Kapodistrian University of Athens, Athens, GRC.
Cureus. 2024 Feb 7;16(2):e53813. doi: 10.7759/cureus.53813. eCollection 2024 Feb.
Background Patients with liver steatosis and diabetes mellitus can benefit from medications like glucagon-like peptide 1 receptor agonists or sodium-glucose co-transporter 2 inhibitors, as far as both hyperglycemia and fatty liver are concerned. Studies comparing members of both these families have not yet been published. We aimed to compare the effects of Empagliflozin and Dulaglutide, focusing primarily on liver steatosis. Methodology This prospective, observational, controlled study enrolled 78 patients from two centers in Athens, Greece. Adults with type 2 diabetes mellitus (DM2) and nonalcoholic fatty liver disease were assigned to one of three groups and received either Empagliflozin or Dulaglutide or any other medical treatment deemed appropriate by their physician. The primary endpoint was the reduction in liver fat fraction, assessed using magnetic resonance imaging-proton density fat fraction. Additionally, we evaluated the proportion of patients achieving a relative reduction above 30% of their initial liver fat concentration. Results The Empagliflozin group exhibited a reduction in liver fat fraction. Furthermore, the percentage of patients with a relative reduction of liver steatosis, >30%, was significantly larger in this group, compared to the Dulaglutide and Control groups. Significant body weight reduction was observed in all three groups, but no improvement in fibrosis assessing scores was noted. Conclusions Empagliflozin is effective in improving liver steatosis, while Dulaglutide does not exhibit a similar effect. Larger studies, comparing these or related agents, are necessary, to further assess benefits in patients with DM2 and nonalcoholic fatty liver.
就高血糖和脂肪肝而言，肝脂肪变性和糖尿病患者可从胰高血糖素样肽1受体激动剂或钠-葡萄糖协同转运蛋白2抑制剂等药物中获益。比较这两类药物的研究尚未发表。我们旨在比较恩格列净和度拉鲁肽的效果，主要关注肝脂肪变性。
这项前瞻性、观察性、对照研究纳入了希腊雅典两个中心的78名患者。患有2型糖尿病（DM2）和非酒精性脂肪性肝病的成年人被分为三组之一，分别接受恩格列净或度拉鲁肽或其医生认为合适的任何其他药物治疗。主要终点是使用磁共振成像-质子密度脂肪分数评估的肝脏脂肪分数的降低。此外，我们评估了肝脏脂肪浓度相对降低超过初始浓度30%的患者比例。
恩格列净组的肝脏脂肪分数降低。此外，与度拉鲁肽组和对照组相比，该组肝脏脂肪变性相对降低>30%的患者百分比显著更高。所有三组均观察到显著的体重减轻，但纤维化评估评分未见改善。
恩格列净在改善肝脂肪变性方面有效，而度拉鲁肽未表现出类似效果。需要进行更大规模的研究来比较这些或相关药物，以进一步评估其对DM2和非酒精性脂肪肝患者的益处。
