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Meta‐analysis of the effect of sodium–glucose cotransporter 2 inhibitors on hepatic fibrosis in patients with type 2 diabetes mellitus complicated with non‐alcoholic fatty liver disease
Author(s) -
Song Tiantian,
Chen Shuchun,
Zhao Hang,
Wang Fei,
Song Huan,
Tian Dongliang,
Yang Qiwen,
Qi Licui
Publication year - 2021
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13645
Subject(s) - medicine , fatty liver , gastroenterology , diabetes mellitus , endocrinology , type 2 diabetes , disease
Abstract Aim This study aimed to analyze the effects of sodium–glucose cotransporter 2 (SGLT2) inhibitors on the indexes of liver fibrosis in patients with type 2 diabetes mellitus complicated with non‐alcoholic fatty liver disease, and also to observe the effects on liver enzymes and liver fat. Methods This meta‐analysis was performed using RevMan 5.3 statistical software. Results SGLT2 inhibitors could significantly reduce the level of hepatic fibrosis index: fibrosis‐4 (mean difference [MD] 0.25, 95% CI −0.39 to −0.11, p = 0.0007); serum type Ⅳ collagen 7s (MD 0.32, 95% CI −0.59 to −0.04, p = 0.02); and ferritin (MD 26.7, 95% CI 50.64, 2.76, p = 0.03). SGLT2 inhibitors could significantly reduce the level of liver enzymes: alanine aminotransferase (MD 3.49, 95% CI −5.1 to 1.58, p < 0.0001); aspartate aminotransferase (MD 3.64, 95% CI −5.10 to −2.18, p < 0.00001); and glutamate aminotransferase (MD 7.13, 95% CI −12.95 to −1.32, p = 0.02). SGLT2 inhibitors could significantly reduce the level of liver fat: liver‐to‐spleen attenuation ratio (MD 0.16, 95% CI 0.10–0.22, p < 0.00001); magnetic resonance imaging proton density fat fraction (MD 1.97, 95% CI −3.49 to −0.45, p = 0.01); liver controlled attenuation parameter (MD 0.29, 95% CI −26.95 to −13.64, p < 0.00001); liver fat score (MD 0.55, 95% CI 1.04 to −0.05, p = 0.03); and liver fat index (MD 11.21, 95% CI −16.53 to −5.89, p < 0.0001). Conclusion SGLT2 inhibitors could improve liver fibrosis, liver enzymes, liver fat, and metabolic indexes in patients with type 2 diabetes mellitus complicated with non‐alcoholic fatty liver disease.