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Effects of sodium‐glucose co‐transporter 2 inhibitors on liver parameters and steatosis: A meta‐analysis of randomized clinical trials
Author(s) -
Coelho Francisca dos Santos,
BorgesCanha Marta,
Hafe Madalena,
Neves João Sérgio,
Vale Catarina,
Leite Ana Rita,
Carvalho Davide,
LeiteMoreira Adelino
Publication year - 2021
Publication title -
diabetes/metabolism research and reviews
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.307
H-Index - 110
eISSN - 1520-7560
pISSN - 1520-7552
DOI - 10.1002/dmrr.3413
Subject(s) - medicine , placebo , fatty liver , meta analysis , steatosis , gastroenterology , liver function , randomized controlled trial , type 2 diabetes , diabetes mellitus , clinical trial , pharmacology , endocrinology , disease , pathology , alternative medicine
Abstract Aims Non‐alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease in Western countries and a common comorbidity with type 2 diabetes (T2D). It lacks effective pharmacotherapy. We aimed to summarize the evidence on the effects of sodium‐glucose co‐transporter 2 (SGLT2) inhibitors on liver structure and function. Materials and methods Meta‐analysis of randomized clinical trials in PubMed, Web of Science and ClinicalTrials.gov from their inception to April 2019. Trials evaluating liver function and/or structure and comparing SGLT2 inhibitors with placebo or other oral antidiabetic drugs in patients with T2D were included. Twenty studies (from 3033) were included. A total of 1950 patients with T2D, with or without NAFLD, were treated with SGLT2 inhibitors for at least 8 weeks, and 1900 patients were used as controls. Independent extraction was carried out by two observers. This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analysis. Results SGLT2 inhibitors induced a significant decrease in serum alanine (−7.43U/L, [95%CI −12.14, −2.71], p < 0.01), in aspartate aminotransferases (−2.83U/L, [−4.71, −0.95], p < 0.01), as well as in gamma glutamyl transferase (−8.21U/L, [−9.52, −6.91], p < 0.01), and an increase in total plasma bilirubin (8.19% [0.79, 15.59], p < 0.01), comparing with placebo or other oral antidiabetic drugs. SGLT2 inhibitors treatment was associated with a decrease in liver steatosis (−3.39% [−6.01, −0.77], p < 0.0.1). Conclusions Treatment with SGLT2 inhibitors improves liver structure and function in patients with T2D. This meta‐analysis suggests that SGLT2 inhibitors are a promising pharmacological approach for treatment of NAFLD.