Gut microbiota predicts treatment response to empagliflozin among MASLD patients without diabetes mellitus

This study aimed to investigate whether gut microbiota could predict treatment response to pharmacological agents among metabolic dysfunction-associated steatotic liver disease (MASLD) patients without diabetes mellitus (DM), as data is lacking. Non-diabetic MASLD patients who used empagliflozin were prospectively recruited, and clinical, anthropometric, laboratory assessments and magnetic resonance imaging-proton density fat fraction (MRI-PDFF) were performed from baseline to week 52 (EOT). Stool samples were collected at baseline and at EOT and shotgun DNA metagenomic sequencing performed to profile microbiome. Putative associated bacterial species and metabolic pathways at baseline were identified for treatment response to empagliflozin, defined as MRI-PDFF decline >=30% at EOT from baseline.