Li Boyu, Wang Ying, Ye Zhikang, Yang Hui, Cui Xiangli, Wang Zhenjun, Liu Lihong
Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
J Pharm Pharm Sci. 2018;21(1):222-235. doi: 10.18433/jpps29831.
Non-alcoholic fatty liver disease (NAFLD) affects about 75% of patients with type 2 diabetes mellitus (T2DM). We conducted a meta-analysis to determine the effect of canagliflozin on fatty liver indexes in T2DM patients.
A literature search of PubMed, Embase and Cochrane was conducted up to March 30, 2017. The liver function test and lipid profile were extracted from randomized controlled trials (RCTs) to evaluate the effect of canagliflozin on fatty liver. Weighted mean differences (WMDs) or relative risks and 95% confidence intervals (CIs) were computed by using either fixed or random-effects models. Sensitivity analysis and publication bias were evaluated.
Our results showed that canagliflozin decreased serum concentrations of alanine amino transferase (WMD: -11.68 [95% CI: -18.95, -10.95]; P<0.001), aspartate amino transferase (WMD: -7.50 [95% CI: -10.61, -4.38]; P<0.001), gamma-glutamyl transferase (WMD: -15.17 [95% CI: -17.73, -12.61]; P<0.001), triglycerides (WMD: -0.10 [95% CI: -0.15, -0.05]; P<0.001) but increased low-density lipoprotein cholesterol (WMD: 0.1 [95% CI: 0.06, 0.13]; P<0.001), high-density lipoprotein cholesterol (WMD: 0.06 [95% CI: 0.05, 0.07]; P<0.001) at week 26 or 52.
Our results indicated that canagliflozin may have a protective effect on fatty liver in T2DM patients. The limitation was that the liver biopsy was hard to obtain in published studies. More RCTs specified on NAFLD are needed to get further information. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.
非酒精性脂肪性肝病（NAFLD）影响约75%的2型糖尿病（T2DM）患者。我们进行了一项荟萃分析，以确定卡格列净对T2DM患者脂肪肝指标的影响。
截至2017年3月30日，对PubMed、Embase和Cochrane进行文献检索。从随机对照试验（RCT）中提取肝功能测试和血脂谱，以评估卡格列净对脂肪肝的影响。使用固定或随机效应模型计算加权平均差（WMD）或相对风险及95%置信区间（CI）。评估敏感性分析和发表偏倚。
我们的结果显示，在第26周或52周时，卡格列净降低了血清丙氨酸氨基转移酶浓度（WMD：-11.68 [95% CI：-18.95，-10.95]；P<0.001）、天冬氨酸氨基转移酶（WMD：-7.50 [95% CI：-10.61，-4.38]；P<0.001）、γ-谷氨酰转移酶（WMD：-15.17 [95% CI：-17.73，-12.61]；P<0.001）、甘油三酯（WMD：-0.10 [95% CI：-0.15，-0.05]；P<0.001），但增加了低密度脂蛋白胆固醇（WMD：0.1 [95% CI：0.06，0.13]；P<0.001）、高密度脂蛋白胆固醇（WMD：0.06 [95% CI：0.05，0.07]；P<0.001）。
我们的结果表明，卡格列净可能对T2DM患者的脂肪肝具有保护作用。局限性在于已发表的研究中难以获得肝活检。需要更多针对NAFLD的RCT以获取进一步信息。本文接受发表后审查。注册读者（见“致读者”）可通过点击本期目录页面上的摘要进行评论。
