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The Combination Empagliflozin/Metformin on the Progression of MASLD
Metabolic dysfunction-associated steatotic liver disease (MASLD) encompasses several cardiometabolic risk factors (obesity, insulin resistance, diabetes, and dyslipidemia), in addition to hepatic steatosis. Management strategies are primarily focused on controlling metabolic risk factors through lifestyle modifications, increased physical activity, and often the use of multiple medications (polypharmacy). Medications targeting metabolic risk factors include antidiabetics, insulin-sensitizing agents, lipid-lowering agents, antihypertensives, and antioxidants. The use of antidiabetics is supported by the fact that MASLD is regarded as an independent risk factor for, and frequently precedes the development of, type 2 diabetes mellitus (T2DM). We investigated whether the combination of empagliflozin/metformin improves MASLD disease outcomes in an experimental model of metabolic syndrome (MS). The empagliflozin/metformin combination therapy mitigates MASLD progression, likely by improving liver and mitochondrial function, and attenuating oxidative stress. Notably, co-therapy shows greater beneficial effects than single treatments. This protective effect appears to involve modulation of key transcription factors regulating lipid and carbohydrate metabolism, as well as influencing endogenous antioxidant defenses.
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  • 18 Dec 2025
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