Empagliflozin Ameliorates Progression From Prediabetes to Diabetes and Improves Hepatic Lipid Metabolism: A Systematic Review

Abstract

Diabetes mellitus (DM) and hepatic steatosis are two of the most common metabolic syndromes that affect the health of people globally. Empagliflozin (EMPA) is a promising drug of choice for the diabetic population. Recent studies have shown its beneficial effects not only on diabetic patients but also on patients suffering from cardiac, hepatic, neurological, or pancreatic anomalies. In this paper, we systematically searched electronic databases to compile literature that focuses on EMPA’s effect on the prediabetic population, diabetic population, and hepatic lipid metabolism. We focus on the mechanism of EMPA, specifically by which it increases insulin sensitivity and fat browning and reduces fat accumulation. Overall, we hypothesized that by its effect on weight loss and reducing inflammatory markers and insulin resistance (IR), EMPA decreases the rate of prediabetes to diabetes conversion. We concluded that by improving hepatic and serum triglyceride, decreasing visceral fat, and its positive impact on hepatic steatosis, the drug improves hepatic lipid metabolism. Further research should be done on this matter.

Clinical Management of Non-alcoholic Steatohepatitis and the Role of the Cardiologist

“…A recent systematic review has also reported potential benefits of empagliflozin, a sodium–glucose cotransporter 2 (SGLT2) inhibitor with beneficial effects on T2D, heart failure and chronic kidney disease in individuals with NAFLD, improving hepatic triglycerides, decreasing visceral fat and reducing inflammatory markers and insulin resistance. [ 44 ]…”

“…43 A recent systematic review has also reported potential benefits of empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor with beneficial effects on T2D, heart failure and chronic kidney disease in individuals with NAFLD, improving hepatic triglycerides, decreasing visceral fat and reducing inflammatory markers and insulin resistance. 44 Glucagon-like peptide-1 (GLP-1) analogues have a multitarget beneficial action in individuals with T2D, lowering plasma glucose, reducing liver steatosis and inflammation, improving cardiac function and protecting against kidney dysfunction. 45 Large retrospective studies on individuals with T2D and small Phase II RCTs in individuals with NAFLD and obesity treated with the GLP-1 analogue liraglutide showed significant dosedependent increases in insulin sensitivity, decreases in liver enzymes and advanced liver fibrosis, and amelioration of advanced liver fibrosis.…”

Prospects of using sodium-glucose co-transporter-2 (SGLT-2) inhibitors in patients with metabolic-associated fatty liver disease (MAFLD)

“…Perakakis N. та співавтори (2021) вагою без ЦД, щодо зниження ознак ІР [115]. Таким чином, з'ясовано, що прийом ЕМПА в осіб з переддіабетом попереджає розвиток явного ЦД і покращує метаболізм ліпідів у печінці [116]. Треба зазначити, що безперервно збільшується кількість наукових праць щодо порівняння позитивних результатів лікування на зменшення чи утримання маси тіла у пацієнтів з ЦД 2-го типу при комбінації інсулінотерапії із іНЗКТГ2 та / чи іДПП-4 або арГПП-1, але у більшості із них не вивчалися прямі / непрямі ефекти на рівні печінки в осіб із МАЖХП.…”