Effect of SGLT2 Inhibitors on Type 2 Diabetes Mellitus With Non-Alcoholic Fatty Liver Disease: A Meta-Analysis of Randomized Controlled Trials - PubMed (original) (raw)

Meta-Analysis

Effect of SGLT2 Inhibitors on Type 2 Diabetes Mellitus With Non-Alcoholic Fatty Liver Disease: A Meta-Analysis of Randomized Controlled Trials

Qiong Wei et al. Front Endocrinol (Lausanne). 2021.

Abstract

Objective: Clinical trials showed that sodium-glucose cotransporter 2 (SGLT2) inhibitors can improve non-alcoholic fatty liver disease (NAFLD). In this work, a meta-analysis of randomized controlled trials was conducted to evaluate the effect of SGLT2 inhibitors on type 2 diabetes mellitus (T2DM) with NAFLD.

Methods: PubMed, Embase, Web of Science, and Cochrane Libraries were used for the systematic literature review to determine eligible studies. A randomized effect model was adapted to perform a meta-analysis on these eligible studies to estimate the combined effect sizes. Differences were expressed as the weighted average difference (WMD) of the continuous results and the 95% confidence interval (CI).

Results: Ten randomized controlled trials with 573 participants were included. SGLT2 inhibitors significantly reduced the levels of alanine transaminase (WMD -5.36 [95% CI: -8.86, -1.85], p = 0.003) and Aspartate Transaminase (WMD -2.56 [95% CI: -3.83, -1.29], p <0.0001). In terms of body composition, liver proton density fat fraction (WMD -2.20 [95% CI: -3.67, -0.74], p = 0.003), visceral fat mass area (WMD -20.71 [95% CI: -28.19, -13.23], p <0.00001), subcutaneous fat areas (WMD -14.68 [95% CI: -26.96, -2.40], p = 0.02) were also significantly reduced.

Conclusion: SGLT2 inhibitors can remarkably reduce hepatic enzymes, hepatic fat and improve body composition. Thus, they may become a new treatment option for NAFLD.

Systematic review registration: PROSPERO, identifier CRD42020215570.

Keywords: liver proton density fat fraction; non-alcoholic fatty liver disease; sodium-glucose cotransporter 2 inhibitors; type 2 diabetes mellitus; visceral fat mass area.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1

Summary of study identification, inclusion, and exclusion.

Figure 2

Quality evaluation chart of included studies.

Figure 3

Meta-analysis of the effect of SGLT2 inhibitors on glycemic indices compared with the control group.

Figure 4

Meta-analysis of the effect of SGLT2 inhibitors on liver function compared with the control group.

Figure 5

Meta-analysis of the effect of SGLT2 inhibitors on body composition compared with the control group.

Figure 6

Meta-analysis of AST level comparisons between SGLT2 inhibitors and the control group based on the control.

Figure 7

Meta-analysis of body weight level comparisons between SGLT2 inhibitors and the control group based on the control.

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Effect of SGLT2 Inhibitors on Type 2 Diabetes Mellitus With Non-Alcoholic Fatty Liver Disease: A Meta-Analysis of Randomized Controlled Trials - PubMed (original) (raw)