Comparison of the therapeutic effect of empagliflozin with pioglitazone and vitamin E on non-alcoholic fatty liver in patients with type 2 diabetes

Abstract

Empagliflozin with pioglitazone and vitamin E have been commonly used for the treatment of non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes but their effects have not still compared. This study aimed to compare the effects of the therapeutic effect of empagliflozin with pioglitazone and vitamin E on NAFLD in patients with type 2 diabetes. Methods: This randomized clinical trial study was lasted for 12 weeks. Patients with NAFLD (n=70) were grouped into two groups empagliflozin (n=35) and pioglitazone + vitamin E (n=35) with the help of a random number table. The patients in the treatment group received empagliflozin 10 mg and metformin 500-2000 mg for 12 weeks while control subjects received pioglitazone 30 mg, vitamin E and metformin 500-2000 mg for 12 weeks. HbA1c, ALT, AST, ALP, creatinine, urea, triglycerides, cholesterol, HDL, LDL, weight, and BMI were evaluated at pre-intervention and post-intervention. The patients were evaluated for fatty liver by sonography in end of 12th week. Findings: The treatment with Empagliflozin significantly decreased body weight, BMI, ALT, AST, ALP, LDL, cholesterol, triglycerides, glucose and HbA1C and increased HDL-C compared with baseline after 12 weeks (P<0.05). However, the treatment with Pioglitazone+vitamin significantly decreased the concentrations of ALT, AST, ALP, and HbA1C and increased BMI compared with baseline after 12 weeks (P<0.05). The patients with grade=0 were more in patients treated with empagliflozin compared with those treated with Pioglitazone+vitamin E.