ObjectiveTo compare the impact of combined therapy with dapagliflozin and metformin versus metformin monotherapy on liver fat content (LFC) and cystatin C (Cys C) levels in patients with type 2 diabetes mellitus (T2DM).

MethodsA total of 121 inpatients with T2DM were enrolled.Patients were divided into metformin monotherapy group (group A, n=51) and dapagliflozin combined with metformin therapy group (group B, n=70) based on their treatment regimen.All patients had been continuously and stably using their respective treatment regimens for more than six months, the levels of LFC were measured using ¹H-magnetic resonance spectroscopy, and serum Cys C levels were assessed using the immunoturbidimetric method.The detailed information of basic demographic and laboratory indexes were collected.The correlations between different laboratory parameters and LFC were analyzed, and the effects of different treatment modalities and other laboratory indicators on LFC and Cys C were explored.

ResultsThere were no statistically significant differences in age, gender composition, disease duration, and body mass index (BMI) between the two groups (P>0.05).Compared to the group A, patients in the group B showed a significant reduction in LFC, serum Cys C levels and total cholesterol (TC) (P < 0.05 to P < 0.01), but had the increases of triglycerides (TG) and very low-density lipoprotein (VLDL) (P < 0.05).The proportion of nonalcoholic fatty liver disease was higher in the group A (90.2%) than that in the group B (30.0%) (P < 0.01).Further correlation analysis revealed that BMI, fasting blood glucose (FBG), and Cys C were associated with LFC (P < 0.05 to P < 0.01).Using LFC as the dependent variable and BMI, FBG, Cys C, disease duration, TC, TG, and medication as independent variables in multiple linear regression analysis, it was found that compared to metformin monotherapy, combined dapagliflozin and metformin therapy reduced LFC by 0.440 units (P < 0.01).Similarly, when using Cys C as the dependent variable and BMI, FBG, LFC, disease duration, TC, TG, and medication as independent variables in multiple linear regression analysis, it was found that combined metformin and dapagliflozin therapy reduced serum Cys C by 0.689 units compared to metformin monotherapy (P < 0.01).

ConclusionsThe combined therapy with metformin and dapagliflozin can effectively reduce the levels of LFC and serum Cys C in T2DM patients, suggesting that such treatment pattern is an important factor influencing LFC and serum Cys C.