Reducing Non-Alcoholic Steatohepatitis

Exclusion Criteria

• •Contraindication to liver biopsy.
• •Documented episode of ketoacidosis.
• •Contraindication or hypersensitivity to empagliflozin.
• •Presence of acute or chronic illness that, in the investigator's opinion, could jeopardize the health or safety of the patient.
• •HbA1c value \> 80 mmol/mol.
• •Inability to safely discontinue thiazolidinedione (pioglitazone) therapy.
• •Liver disease of other etiologies, including viral hepatitis B and C, autoimmune hepatitis, alpha-1 antitrypsin deficiency, hemochromatosis, Wilson's disease, primary sclerosing cholangitis, primary biliary cholangitis, or liver cirrhosis (Child-Pugh A, B, C) of any etiology.
• •Use of medications or medical procedures that induce liver steatosis or fibrosis.
• •Proven alcohol use exceeding: Men \> 30 g/day, Women \> 20 g/day.
• •History of acute or chronic pancreatitis.
• •Known dependence on or use of illegal addictive substances.
• •Significant weight gain or loss: +/- 10% in the last three months.
• •Diagnosis of malignant disease (except treated benign or skin tumors) in the last 5 years.
• •Stroke or myocardial infarction in the last 6 months.
• •Clinically significant dyspnea New York hear association (NYHA) grade III or higher.
• •Proven heart failure with a left ventricular ejection fraction below 40%.
• •estimated glomerular filtration rate(eGFR) values lower than 30 ml/min/1.73 m² or creatinine clearance lower than 30 ml/min.
• •Proven diabetic foot syndrome requiring amputation or with an existing defect.
• •Planned pregnancy, ongoing lactation or pregnancy, positive pregnancy test, lack of at least two adequate contraceptive methods in women of childbearing potential.
• •Participation in another interventional study within the last 3 months before study entry.
• •Legal incapacity or reduced ability to perform legal acts.
• •Serving a prison sentence.