- Empagliflozin is linked to reduced liver fat content (LFC) in patients with recent-onset and nearly normoglycemic type 2 diabetes (T2D).
- Effect seen regardless of nonalcoholic fatty liver disease (NAFLD) status.
- It also reduces weight without affecting insulin sensitivity.
Why this matters
- Patients with T2D are at increased risk for NAFLD and for progression to nonalcoholic steatohepatitis, fibrosis, and cirrhosis.
- NAFLD is linked to cardiovascular disease and diabetes-related chronic kidney disease and retinopathy.
- 84 patients with T2D were randomly assigned to 25 mg/day empagliflozin or placebo; 65 completed 24 weeks.
- Funding: German Federal Ministry of Health; Ministry of Innovation, Science, and Research of North Rhine-Westphalia; German Federal Ministry of Education and Research.
- At 24 weeks, placebo-corrected absolute (−1.8%; P=.02) and relative decreases in LFC (−22%; P=.009) were seen with empagliflozin, corresponding to 2.3-fold higher relative reduction.
- No significant changes with empagliflozin in whole body/skeletal muscle and hepatic insulin sensitivity at low (50%; P=.05) or high (12%; P=.36) insulin clamp conditions.
- With empagliflozin:
- 2.5-kg weight loss (P<.001>
- 0.7-mmol/L fasting blood glucose drop (P=.01), and
- No change in HbA1c.
- All participants had well-controlled, short-duration T2D.
- No meal testing, liver biopsies.