Beneficial effects of SGLT2 Inhibitors on Fatty Liver in Type 2 Diabetes Mellitus
DOI:
https://doi.org/10.70749/ijbr.v3i7.2075Keywords:
Type II Diabetes Mellitus, Non-Alcoholic Fatty Liver Disease, Sodium-Glucose Transporter 2 Inhibitors, Liver Function Tests.Abstract
Objectives: To evaluate the effects of treatment with SGLT 2 inhibitors on fatty liver disease in patients with type 2 diabetes mellitus. Study design: Quasi-experimental study. Place and duration of study: Department of Medicine, PAF hospital Islamabad from Apr-2024 to Mar-2025. Methods: A total of 100 type 2 diabetic patients diagnosed with non-alcoholic fatty liver disease (Grade 1–3) were enrolled and divided into two equal groups. The study group received SGLT2 inhibitor in addition to their existing antidiabetic treatment while controls continued standard antidiabetic treatment. Baseline demographic, anthropometric data, blood glucose and liver enzyme tests were recorded, while the hepatic steatosis was assessed and graded by ultrasound. The primary outcome was the significance of difference in hepatic steatosis grade, while secondary outcomes included significance of difference in liver enzyme levels, glycemic control, waist circumference, and body weight after six months treatment. Results: The mean age of patients was 53.26 ± 9.03 years, with males comprising 59% and females 41% of the study population. At 6-month follow-up, significantly more patients (18%) in the study group achieved complete resolution of steatosis (Grade 0) compared to 2% in the control group, with a significant difference in steatosis grade distribution (χ² = 9.476, df = 3, p = 0.024). Patients on SGLT2 inhibitors showed significant decreased levels of ALT (p = 0.02), AST (p = 0.02), waist circumference (p = 0.01), body weight (p = 0.02) and HbA1c (p = 0.01) compared to the controls. Conclusion: SGLT2 inhibitors show benefits in terms of improved hepatic steatosis, liver enzymes, glycemic control, and anthropometric measures suggesting their potential role in managing the diabetic patients with fatty liver disease.
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1. Marginean, C. M., Pirscoveanu, D., Cazacu, S. M., Popescu, M. S., Marginean, I. C., Iacob, G. A., & Popescu, M. (2024). Non-alcoholic fatty liver disease, awareness of a diagnostic challenge—A clinician’s perspective. Gastroenterology Insights, 15(4), 1028-1053.
https://doi.org/10.3390/gastroent15040071
2. Vetrano, E., Rinaldi, L., Mormone, A., Giorgione, C., Galiero, R., Caturano, A., Nevola, R., Marfella, R., & Sasso, F. C. (2023). Non-alcoholic fatty liver disease (NAFLD), type 2 diabetes, and non-viral Hepatocarcinoma: Pathophysiological mechanisms and new therapeutic strategies. Biomedicines, 11(2), 468.
https://doi.org/10.3390/biomedicines11020468
3. Akter, S. (2022). Non-alcoholic fatty liver disease and Steatohepatitis: Risk factors and pathophysiology. Middle East Journal of Digestive Diseases, 14(2), 167-181.
https://doi.org/10.34172/mejdd.2022.270
4. Lee, B., Lee, Y., Park, C., Rhee, E., Lee, W., Kim, N., Choi, K. M., Park, K., Choi, Y., Cha, B., & Lee, D. H. (2020). Non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus: A position statement of the fatty liver research group of the Korean Diabetes Association. Diabetes & Metabolism Journal, 44(3), 382.
https://doi.org/10.4093/dmj.2020.0010
5. Mantovani, A., & Dalbeni, A. (2021). Treatments for NAFLD: State of art. International Journal of Molecular Sciences, 22(5), 2350.
https://doi.org/10.3390/ijms22052350
6. Padda, I. S., Mahtani, A. U., & Parmar, M. (2023). Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitors. PubMed; StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK576405/
7. Salvatore, T., Galiero, R., Caturano, A., Rinaldi, L., Di Martino, A., Albanese, G., Di Salvo, J., Epifani, R., Marfella, R., Docimo, G., Lettieri, M., Sardu, C., & Sasso, F. C. (2022). An overview of the Cardiorenal protective mechanisms of SGLT2 inhibitors. International Journal of Molecular Sciences, 23(7), 3651.
https://doi.org/10.3390/ijms23073651
8. Popoviciu, M. S., Paduraru, L., Rahman, M., Supti, F. A., Stoica, R. A., Reurean Pintilei, D., Bica, C. I., & Cavalu, S. (2024). The effects of SGLT2 inhibitors in patients with metabolic dysfunction-associated fatty liver disease; a narrative review. Journal of Mind and Medical Sciences, 11(1), 62-77.
https://doi.org/10.22543/2392-7674.1439
9. Cuttone, A., Cannavò, V., Abdullah, R. M., Fugazzotto, P., Arena, G., Brancati, S., Muscarà, A., Morace, C., Quartarone, C., Ruggeri, D., Squadrito, G., & Russo, G. T. (2025). Expanding the use of SGLT2 inhibitors in T2D patients across clinical settings. Cells, 14(9), 668.
https://doi.org/10.3390/cells14090668
10. Kamal, S. (2023). Non alcoholic fatty liver disease (NAFLD) – An emerging challenge. National Journal of Health Sciences, 8(4), 140-141.
https://doi.org/10.21089/njhs.84.0140
11. Gameil, M. A., Abdelgawad, M. S., Bahgat, M. H., Elsebaie, A. H., & Marzouk, R. E. (2020). Influence of sodium glucose Co-transporter 2 inhibitors on fatty liver index parameters in type 2 diabetes mellitus. The Egyptian Journal of Internal Medicine, 32(1).
https://doi.org/10.1186/s43162-020-00013-0
12. Gerstenmaier, J. F., & Gibson, R. N. (2014). Ultrasound in chronic liver disease. Insights into Imaging, 5(4), 441-455.
https://doi.org/10.1007/s13244-014-0336-2
13. Scheen, A. (2019). Beneficial effects of SGLT2 inhibitors on fatty liver in type 2 diabetes: A common comorbidity associated with severe complications. Diabetes & Metabolism, 45(3), 213-223.
https://doi.org/10.1016/j.diabet.2019.01.008
14. Euh, W., Lim, S., & Kim, J. (2021). Sodium-glucose cotransporter-2 inhibitors ameliorate liver enzyme abnormalities in Korean patients with type 2 diabetes mellitus and nonalcoholic fatty liver disease. Frontiers in Endocrinology, 12.
https://doi.org/10.3389/fendo.2021.613389
15. Amin, M. A., Sadik, N. A., Saad, H. A., Fawzy, M., & Elsheimy, H. A. (2025). The effect of SGLT2 inhibitors on hepatic steatosis detected by MRI-PDFF in patients with type 2 diabetes mellitus and metabolic-associated steatotic liver disease. Internal and Emergency Medicine, 20(4), 1025-1033.
https://doi.org/10.1007/s11739-025-03902-w
16. Sajad, Q., Khan, K. A., Khan, A. Z., Khan, D., Iqbal, J., & Mustafa, M. I. (2025). Beyond glucose: Empagliflozin’s impact on fatty liver in patients with type 2 diabetes; A true game changer. Indus Journal of Bioscience Research, 3(2), 193-198.
https://doi.org/10.70749/ijbr.v3i2.663
17. Amjad, W., Malik, A., Qureshi, W., Dennis, B., Mumtaz, M., Haider, R., Jamal, S., Jaura, F., & Ahmed, A. (2022). Sodium-glucose cotransporter-2 inhibitors improve liver enzymes in patients with Co-existing non-alcoholic fatty liver disease: A systematic review and metanalysis. Gastroenterology Review, 17(4), 288-300.
https://doi.org/10.5114/pg.2021.112365
18. Yaribeygi, H., Maleki, M., Jamialahmadi, T., Moallem, S. A., & Sahebkar, A. (2023). Hepatic benefits of sodium-glucose cotransporter 2 inhibitors in liver disorders. PubMed, 22, 403–414.
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