Combined effect of metformin and ezetimibe on PPAR-γ and adiponectin gene expression and biochemical parameters in MAFLD patients with type 2 diabetes

This study aimed to assess the efficacy of ezetimibe in combination with metformin versus metformin alone in patients with metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes mellitus. Patients were randomly divided into two groups: one receiving ezetimibe and metformin (Met + EZY) and the other receiving metformin alone (Met group) for six months. Parameters were measured at baseline (T1), after three months (T2), and after six months (T3). The findings indicated that insulin levels and HOMA-IR exhibited a significant decrease from T1 to T2 in the Met + EZY group (p < 0.05). Malondialdehyde (MDA) and triglycerides levels also demonstrated significant decreases from T1 to T2 in the Met + EZY group (p < 0.05). The expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) and adiponectin (ADIPO) showed a significant increase from T1 to T2 in the Met + EZY group (p < 0.01). Additionally, ADIPO expression showed a significant increase from T1 to T3 (p < 0.001) in both groups. When comparing the two treatment groups, PPAR-γ and ADIPO expression were significantly higher in the Met + EZY group during T2 and T3 compared to the Met group (p < 0.001). Combination therapy appears to be more effective than metformin treatment alone and should be used cautiously.