Thioredoxin-interacting protein TXNIP as a promising diagnostic marker for metabolic-associated fatty liver disease in patients with type 2 diabetes

Introduction . Metabolic-associated fatty liver disease (MAFLD) is a common disease that has a pathogenesis-based relationship with type 2 diabetes (T2D). Aim. To determine the levels of TXNIP protein in patients with MAFLD and T2D who were on metformin monotherapy, to compare these levels with the findings of MRI of the liver, and to assess changes in TXNIP protein levels six months after starting treatment with glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors. Materials and methods . The study included 49 patients (34 female and 15 male) with T2D and MAFLD, aged 55 ± 8 years, who were followed up at the outpatient clinic of Almazov National Medical Research Centre (St. Petersburg) from January 2023 to March 2024. The eligibility criteria included BMI values of 25–40 kg/m² and a glycated hemoglobin level not exceeding 9.5%. Results. The study showed that serum TXNIP protein levels were positively correlated with the severity of MAFLD assessed based on MRI findings. Furthermore, TXNIP levels significantly decreased as a result of therapy with GLP-1RAs and SGLT-2 inhibitors. Conclusion. These correlation data suggest that the TXNIP level could be used as a promising diagnostic marker in patients with MAFLD and T2D, both at the stage of diagnostic evaluation and when considering the outcomes of ongoing therapy.