Endocrine Abstracts

JOINT174

Background and aims: Particularly the association between type 2 diabetes (T2D) and comorbid disorders were linked to an increased risk of nonalcoholic steatohepatitis (NS). Early biomarker such as fetuin-A can help predict of insulin resistance, dyslipidemia and metabolic disorders in patients with NS. The use of gliflozins on hepatokines in patients with T2D and NS has encountered conflicting opinions. We aimed to compare the effectiveness of gliflozins on NS.

Materials and methods: 36 participants with T2D and NS (58,3% males, 41,7% females; aged - 57,54±9,24 years; duration of T2D-14,67±5,14 years; body mass index (BMI)- 37,49±4,32 kg/m²; waist circumference (WC)-122,24±11,32 cm; glycated hemoglobin (HbA₁C)-8,12±0,23%; hepatic fibrosis (index FIB-4)-1,34±0,25; METAVIR score at liver elastography-8,63±0,46 kPa) were comprehensively investigation including physical examination, laboratory and instrumental results at baseline and 3 months following the treatment. Fetuin-A using kits for the enzyme-linked immune-sorbent assay. All patients were divided into three groups: Gr A (n = 12) received basic medical therapy (BMT) which included metformin (MET- 2000 mg/day), alpha-lipoic acid (600 mg/day) and rosuvastatin (10 mg/day) in combination with insulin therapy; Gr B (n = 12) subjects add-on to BMT and dapagliflozin (DAPA -10 mg/day); Gr С (n = 12) received BMT and empagliflozin (EMPA-10-25 mg/day).

Results: After 3 months of treatment the greater reduction in WC were observed in Gr B (-3,12±0,04 cm, P <0,01) and Gr C (-2,89±0,02 cm, P <0,01) vs compared to Gr A (-0,75±0,02 cm), concurrently BMI decreased significantly in the subjects receiving DAPA (-1,92± 2,35 kg/m², P <0,05) and EMPA (-1,22± 2,48 kg/m², P <0,05). HbA₁C level was lowered by 0,76% (Gr A); 0,99% (Gr B) and 0,96% (Gr C). FIB-4 decreased significantly in patints of Gr B (1,28±0,13 to 0,61±0,05, P <0,01) and Gr C (1,22±0,19 to 0,63±0,03, P <0,01) that in the Gr A (1,27±0,13 to 1,20±0,08). Due to the positive result of METAVIR score was higher in subjects of Gr B (8,64±1,33 vs 5,61±0,25 kPa, P <0,01) and Gr C (8,59±1,45 vs 5,59±0,32 kPa; P <0,01) compared with the Gr A (8,49±1,53 vs 7,74±1,22 kPa). As regards to effect DAPA and EMPA on fetuin-A positive effect (0,8-0,9-time) in both groups. Fetuin-A was positively correlated with BMI (r = 0,662, P = 0,004), WC (r = 0,758, P = 0,001), FIB-4 (r = 0,672, P = 0,003) and METAVIR score (r = 0,524, P = 0,002). The gliflozins resulted in a decrease in content hepatic fibrosis, fetuin-A compared Gr A.

Conclusions: Our study demonstrated the positive effect of gliflozins activates additional hepatoprotective mechanisms and would become an innovation therapeutic option for the treatment of persons with NS.