Comparative Clinical Study Between Empagliflozin Versus Pioglitazone in Non-diabetic Patients With Non-alcoholic Steatohepatitis

Inclusion Criteria: * Non-diabetic patients. * Both males and females. * Age \>18 years old. * Patient with body mass index (BMI) \> 30 kg/m2. * Patients with established diagnosis of NASH based on liver ultrasonography, mild to moderate elevation in aminotransferase activities (\>2 but \<5 times upper limit of normal), hepatic steatosis index (HSI) \>36, and HAIR score of 2 or 3. Exclusion Criteria: * Patients with BMI \> 40 kg/m2. * Patients with type 2 diabetes mellitus (T2DM) on the basis of a fasting plasma glucose (FPG) level ≥ 126 mg/dl (7mmol/L) or glycated hemoglobin (HbA1c) \> 6.5% (48 mmol/mol). * Alcohol consumption greater than 20 g per day for women or greater than 30 g for men for at least three consecutive months over the past 5 years. * History of viral hepatitis, hemochromatosis, Wilson's disease, autoimmune hepatitis, primary biliary cirrhosis, sclerosing cholangitis, biliary obstruction, alpha-1 antitrypsin deficiency. * Patients on medications interfere with lipid and carbohydrate metabolisms. * Patients with heart failure (New York Heart Association (NYHA) class 2-4). * Patients with history of cardiovascular events within the past 3 months. * Patients with renal impairment (eGFR\> 45 mL/min/ 1.73 m2). * Patients with cancer or with a history of cancer treatment over the past 2 years. * Patients with thyroid disorder. * Patients on medications associated with steatosis such as Non-steroidal anti-inflammatory drugs (NSAIDs), amiodarone, tamoxifen, estr…