Introduction: Medications currently taken by patients with NAFLD target concomitant metabolic diseases such as hypertension, dyslipidemia and diabetes.

Aim: The aim of the study was to examine the effectiveness of lixisenatide and dapagliflozin in NAFLD patients with type 2 diabetes mellitus (T2DM) compared with sitagliptin and pioglitazone.

Methods: T2DM patients with NAFLD (n=306) were included in the study. Patients were divided in 4 groups according to their treatment with lixisenatide (n=62), dapagliflozin (n=85), pioglitazone (n=67) and sitagliptin (n=92). All patients also received metformin. Mean follow-up period was 76 weeks ± 2 weeks. The evaluation of liver fibrosis depended on calculation of aspartase aminotransferase (AST) to platelet counts ratio (APRI) index. All patients went through an ultrasonography before being included in the study and after the end of the study.

Results: There were no differences between groups in patient age (p=0.256), duration of T2DM (p=0.283), Body Mass Index (BMI) (p=0.337) and HbA1c (p=0.156). There was a greater improvement of APRI index for the lixisenatide group (1.07 (0.46-1.23) vs. 0.74 (0.38-0.90) p<0.001) compared to dapagliflozin (1.12 (0.59-1.22) vs. 0.83 (0.32-1.01) p=0.010) to pioglitazone (1.10 (0.49-1.27) vs. 0.90 (0.41-1.04), p=0.014), and sitagliptin (1.01 (0.39-1.14) vs. 0.99 (0.38-1.15) vs. 0.98 (0.36-1.14) p=0.366). APRI index’s improvement was accompanied by a significant change of fatty liver in ultrasonography. The decrease of body weight in the lixisenatide (p<0.001) and in the dapagliflozin group (p=0.028) was statistically significant.

Conclusions: Administration of lixisenatide and dapagliflozin led not only to good control of T2DM but also improvement of liver inflammation, alteration of liver fibrosis, and reduction of body weight, which are particularly important factors in patients with T2DM.


A. Koutsovasilis: None. A. Sotiropoulos: None. M. Pappa: None. D. Papadaki: None. V. Kordinas: None. C. Tamvakos: None. M. Bourikou: None. S. Bousboulas: None. T. Peppas: None.

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