Open AccessEffects of sodium–glucose cotransporter 2 inhibitors on non‐alcoholic fatty liver disease in patients with type 2 diabetes: A meta‐analysis of randomized controlled trials
Author(s) -
Xing Baodi,
Zhao Yuhang,
Dong Bingzi,
Zhou Yue,
Lv Wenshan,
Zhao Wenjuan
Publication year - 2020
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.13237
Subject(s) - medicine , fatty liver , gastroenterology , diabetes mellitus , randomized controlled trial , type 2 diabetes , meta analysis , confidence interval , cochrane library , type 2 diabetes mellitus , endocrinology , disease
Aims/Introduction Non‐alcoholic fatty liver disease (NAFLD) is increasingly common in patients with type 2 diabetes mellitus. Currently, some studies have found that sodium–glucose cotransporter 2 (SGLT2) inhibitors, a new hypoglycemic drug, can improve non‐alcoholic fatty liver in addition to its hypoglycemic effect. Thus, we undertook a meta‐analysis of randomized controlled trials to evaluate the efficacy of SGLT2 inhibitors on the treatment of NAFLD. Materials and Methods PubMed, Embase and the Cochrane Library were searched for randomized controlled trials of SGLT2 inhibitors in patients with NAFLD and type 2 diabetes mellitus up to 1 October 2019. Differences were expressed as weight mean difference (WMD) with 95% confidence interval (CI) for continuous outcomes. The I 2 statistic was applied to evaluate the heterogeneity of studies. Results A total of six trials including 309 patients were selected into our meta‐analysis. SGLT2 inhibitors could reduce alanine aminotransferase (WMD −11.05 IU/L, 95% CI −19.85, −2.25, P = 0.01) and magnetic resonance imaging proton density fat fraction (WMD −2.07%, 95% CI −3.86, −0.28, P = 0.02). However, SGLT2 inhibitors did not reduce aspartate aminotransferase (WMD −1.11 IU/L, 95% CI −2.39, 0.17, P = 0.09). In addition, secondary outcomes, such as bodyweight and visceral fat area, were also reduced (WMD −1.62 kg, 95% CI −2.02, −1.23, P < 0.00001; WMD −19.98 cm 2 , 95% CI −27.18, −12.79, P < 0.00001, respectively). Conclusions SGLT2 inhibitors can significantly decrease alanine aminotransferase and liver fat, accompanied with weight loss, which might have a positive effect on fatty liver in patients with type 2 diabetes mellitus. The limitation is that the sample size of the studies was small. Therefore, more large randomized controlled trials specified on NAFLD are required to evaluate these results.