Abstract Body: Introduction and Objective: Metabolic dysfunction–associated steatotic liver disease (MASLD) is a condition where fat accumulation and inflammation in the liver occurs. Our goal was to examine how different medication regimens used for type 2 diabetes, such as glucagon-like peptide 1 receptor analogs (GLP-1A +/- insulin or metformin), sodium-glucose transport protein-2 inhibitors (SGLT2i +/- ins or met), Metformin (+/- ins), and insulin(ins) alone are associated with different fibrosis scores (FIB-4) and lipid parameters.
Methods: We conducted a cross-sectional single-time point chart review of their FIB-4 scores at or above 1.3and 1.8. A total of 246 recent patient visits were screened, of which 121 were included based on the FIB-4 criteria for a period of 33 months. The data was analyzed using Mann-Whitney non-parametric t-test.
Results: Patients at or above 1.3 cohort had a mean age of 72.09±0.7, the mean BMI of the same cohort was 30.31±0.56 and mean A1C was 7.7±0.13. Patients were mostly on INS only group (32.23%)
In the same cohort, with FIB4 of 1.8 and above, Metformin (+/- ins) group had a FIB-4 score of 2.234±0.19 (n=9), while SGLT2i (+/- ins or met) group had a score of 2.956±0.34 (n=16). GLP-1A (+/- ins or met) group had a lower score of 2.283±0.13 (n=14) compared to ins alone group’s score of 3.319±0.40 (n=18) (p=0.04).
In the same cohort, the mean Non-HDL Cholesterol was lowest in Metformin (+/- ins) group at 83.38±6.2.
The mean Triglyceride of Metformin (+/- ins) group had a lower value of 104.3±6.7 compared to GLP-1A (+/- ins or met) group with 153.1±18.6 (p=0.02). SGLT2i (+/- ins or met) group had 125.0±17.2 and ins alone group had 126.2±22.2 with no noted difference across groups. On Fibroscan cohort, GLP-1A group had an average kPA of 5.7±2.1 (n=3) while SGLT2i group had 8.0±1.4 (n=11) and Metformin only group had 2.8±0.15(n=2). Conclusion: In both cohorts with FIB-4 at 1.3 or 1.8, patients on metformin group had the lowest FIB-4 score, followed by GLP1A. Similarly Metformin group appears to have lowest triglyceride and non-HDL cholesterol level. Fibroscan results appear to to follow similar trend. From our study it appears Metformin followed by GLP1A, in an elderly population provides protection from liver hepato-steatosis with lowest lipid profiles.