Empagliflozin is linked to reduced liver fat in well-controlled T2D

  • Kahl S & al.
  • Diabetes Care
  • 1 Feb 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.
  • Also with empagliflozin: 
  • Reduced serum uric acid: −74 mol/L (P<.001>
  • Increased high-molecular-weight adiponectin: 36% (P<.001>

Limitations

  • All participants had well-controlled, short-duration T2D.
  • No meal testing, liver biopsies.