Independent effects of Metformin and Dapagliflozin on Fetuin-A, hepatic and pancreatic fat, and hepatic fibrosis in Asian Indians with type 2 diabetes

Previously we have reported decrease in hepatic and pancreatic fat fraction with Dapagliflozin (DAPA). In this research, we evaluated the effects of Metformin intervention for 120 days on hepatic fat fraction (HFF) and pancreatic fat fraction (PFF), hepatic fibrosis, and Metformin and DAPA, on Fetuin-A levels in patients with type 2 diabetes (T2D). Patients were given 1000 mg of Metformin/day (n, 15) and DAPA 10 mg/day (n, 30) for a period of 120 days. Changes in anthropometry, surrogate markers of insulin resistance, body composition, vibration-controlled transient elastography (VTE, for CAP, and kPa) parameters, HFF) and PFF (both by MRI-PDFF) and serum fetuin-A levels were evaluated. After 120 days of treatment with Metformin and DAPA, a significant reduction in body weight, body mass index (BMI), percentage body fat, waist and hip circumferences, and total skinfold thickness was observed. A significant reduction in fetuin-A was seen with both Metformin and DAPA treatment, previously not reported for latter drug. Metformin significantly decreased CAP and kPa (VTE) but did not decrease HFF and PFF. Metformin and DAPA, after 120 days of use, reduced Fetuin-A levels, and Metformin decreased CAP and kPa but not HFF and PFF. Reduction of Fetuin-A levels with Metformin and DAPA have important pathophysiological implications for T2D in Asian Indians.