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The Effect of Empagliflozin on Non-alcoholic Steatohepatitis and Liver Enzymes Levels in Patients with Type 2 Diabetes Mellitus: A Randomized Clinical Trial

Khatereh Nasiri Mehr, Javad Shokry, Hemmat Gholinia Ahangar, Manijeh Ebrahimzadeh Pirshahid, Seyedeh Fatere Seyedalipour, A. Emami, N. Meftah

Hepatitis Monthly, 2025

140 participants · 2 citations

Abstract

Background: Non-alcoholic steatohepatitis (NASH) is a growing health concern closely linked to insulin resistance, a key factor in the development of type 2 diabetes mellitus (T2DM). Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, has been shown to reduce fat mass, improve cardiovascular outcomes, and lower mortality rates. Objectives: This study aimed to evaluate the potential of empagliflozin in reducing liver enzyme levels in patients with T2DM, providing insight into its role in mitigating liver damage associated with NASH. Methods: This was a 24-week, prospective, randomized, placebo-controlled clinical trial conducted at Ayatollah Rouhani Hospital, Babol. A total of 140 eligible patients were randomly assigned to either the placebo or treatment group. The placebo group received standard antidiabetic therapy, while the treatment group received 10 mg of empagliflozin daily in addition to their standard treatment. Data were collected at baseline, and after 12 and 24 weeks. Results: Data from 110 patients were analyzed, with 55 participants in each group. The treatment group showed a significant reduction in aspartate aminotransferase (AST) (P < 0.001), alanine aminotransferase (ALT) (P < 0.001), direct bilirubin (P = 0.001), HDL (P < 0.001), and LDL (P = 0.02) levels. The average fatty liver grade in the treatment group also decreased significantly throughout the trial period (P < 0.001). Changes in AST, ALT, and HDL levels within the treatment group…

How strong is the evidence?

Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 140 participants or records.

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