Abstract: Objective The aim of this study was to investigate the efficacy of semaglutide in the treatment of patients with type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). Methods 104 patients with T2DM and NAFLD were encountered in our hospital between June 2022 and June 2024, and were randomly assigned to receive oral dapagliflozin and metformin in 52 cases in the control, or subcutaneous injection of semaglutide at base of oral dapagliflozin and metformin in another 52 cases in the observation group for 24 weeks. Blood biochemical parameters and blood glucose index, including glycosylated hemoglobin (HbA1c) were routinely detected, and liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were measured by transient elastography. The visceral adiposity index (VAI) and lipid accumulation product index (LAP) were calculated. Results By end of 24-week treatment, serum alanine aminotransferase, aspartate aminotransferase and CAP in the observation group were (34.9±3.7)U/L, (35.8±3.6)U/L and (270.7±30.6)dB/m, all significantly lower than [(59.1±3.3)U/L, (51.1±3.9)U/L and (289.7±20.5)dB/m, respectively, P＜0.05] in the control; fasting blood glucose, postprandial 2 h blood glucose and HbA1c were(6.1±0.5)mmol/L, (7.5±0.9)mmol/L and (6.2±0.7)%, all much lower than [(6.6±0.6)mmol/L, (9.9±0.6)mmol/L and (7.1±0.6)%, respectively, P＜0.05] in the control group; total cholesterol, triacylglycerol, low density lipoprotein cholesterol, VAI and LAP were(5.3±0.4)mmol/L, (2.1±0.2)mmol/L, (2.7±0.4)mmol/L, (103.7±9.2) and (55.9±6.9), all much lower than [(5.9±0.5)mmol/L, (2.7±0.3)mmol/L, (3.5±0.6)mmol/L, (119.2±10.3) and (61.4±7.2), respectively, P＜0.05], while high density lipoprotein cholesterol level was (1.3±0.3)mmol/L, much higher than [(1.0±0.2)mmol/L, P＜0.05] in the control group. Conclusion The clinical efficacy of semaglutide in the treatment of patients with T2DM and NAFLD at base of dapagliflozin and metformin is short-termly satisfactory, which might be related to modulation of glucose-lipid metabolism.

Key words: Non-alcoholic fatty liver disease, Type 2 diabetes mellitus, Semaglutide, Dapagliflozin, Metformin, Therapy