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Meta-analysis of the effects of sodium glucose cotransporter 2 inhibitors in non-alcoholic fatty liver disease patients with type 2 diabetes.

作者信息

Sinha Binayak, Datta Debasis, Ghosal Samit

机构信息

Department of Endocrinology, AMRI Hospitals Kolkata India.

Department of Hepatology, Fortis Hospital Kolkata India.

出版信息

JGH Open. 2020 Dec 7;5(2):219-227. doi: 10.1002/jgh3.12473. eCollection 2021 Feb.


DOI:10.1002/jgh3.12473
PMID:33553659
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7857274/
Abstract

BACKGROUND AND AIM: Sodium glucose cotransporter 2 inhibitors (SGLT-2i), by way of their unique mode of action, present an attractive strategy for the treatment of type 2 diabetes and non-alcoholic fatty liver disease (NAFLD), which often coexist and may lead to severe complications. However, the evidence for treatment with SGLT-2i is limited to small heterogeneous studies. Therefore, this meta-analysis was conducted to deduce the effects of SGLT-2i in NAFLD with type 2 diabetes (T2D). METHODS: A web-based search identified nine randomized controlled trials from the Cochrane Library, Embase, and PubMed for this meta-analysis. The Comprehensive Meta-Analysis Software version 3 was used to calculate the effect size. RESULT: The outcomes of interest were analyzed from a pooled population of 11 369 patients-7281 on SGLT-2i and 4088 in the control arm. SGLT-2i therapy produced a statistically significant improvement in alanine aminotransferase [standardised mean difference (SDM), -0.21, 95% confidence interval (CI), -0.32 to -0.10, < 0.01], aspartate aminotransferase (Standardised mean difference (SDM), -0.15, 95% CI, -0.24 to -0.07, < 0.01), and liver fat as measured by proton density fat fraction (SDM, -0.98, 95% CI, -1.53 to -0.44, < 0.01) in comparison to standard of care or placebo. In addition, there was a significant reduction in glycosylated hemoglobin (SDM, -0.37, 95% CI, -0.60 to -0.14, < 0.01) and weight (SDM, -0.58, 95% CI, -0.93 to -0.23, < 0.01) in the SGLT-2i arm. CONCLUSION: This meta-analysis provides a convincing signal that SGLT-2i have a salutary effect on NAFLD in type 2 diabetes (T2D), probably driven by an improvement of glycemia and body weight, which in turn attenuates hepatic inflammation and hepatic fat accumulation.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd1/7857274/a18847f8eba0/JGH3-5-219-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd1/7857274/3816494deab4/JGH3-5-219-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd1/7857274/41fce5280476/JGH3-5-219-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd1/7857274/6bed7660bcac/JGH3-5-219-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd1/7857274/a18847f8eba0/JGH3-5-219-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd1/7857274/3816494deab4/JGH3-5-219-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd1/7857274/41fce5280476/JGH3-5-219-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd1/7857274/6bed7660bcac/JGH3-5-219-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccd1/7857274/a18847f8eba0/JGH3-5-219-g004.jpg

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Meta-analysis of the effects of sodium glucose cotransporter 2 inhibitors in non-alcoholic fatty liver disease patients with type 2 diabetes.

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[3]
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[4]
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[5]
MASLD treatment-a shift in the paradigm is imminent.

Front Med (Lausanne). 2023-12-11

[6]
The role of anti-diabetic drugs in NAFLD. Have we found the Holy Grail? A narrative review.

Eur J Clin Pharmacol. 2024-1

[7]
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[8]
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[9]
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[10]
SGLT-2 Inhibitors in NAFLD: Expanding Their Role beyond Diabetes and Cardioprotection.

Int J Mol Sci. 2022-3-13

本文引用的文献

[1]
Effects 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.

J Diabetes Investig. 2020-9

[2]
The SGLT2 Inhibitor Empagliflozin Ameliorates the Inflammatory Profile in Type 2 Diabetic Patients and Promotes an Antioxidant Response in Leukocytes.

J Clin Med. 2019-11-1

[3]
A multidisciplinary approach to the management of NAFLD is associated with improvement in markers of liver and cardio-metabolic health.

Frontline Gastroenterol. 2019-10

[4]
Empagliflozin Effectively Lowers Liver Fat Content in Well-Controlled Type 2 Diabetes: A Randomized, Double-Blind, Phase 4, Placebo-Controlled Trial.

Diabetes Care. 2019-9-20

[5]
Effects of sodium-glucose co-transporter-2 inhibitors on serum alanine aminotransferase levels in people with type 2 diabetes: A multi-institutional cohort study.

Diabetes Obes Metab. 2020-1

[6]
The effects of ipragliflozin on the liver-to-spleen attenuation ratio as assessed by computed tomography and on alanine transaminase levels in Japanese patients with type 2 diabetes mellitus.

Diabetol Int. 2017-1-3

[7]
Impact of sodium glucose cotransporter 2 inhibitor on histological features and glucose metabolism of non-alcoholic fatty liver disease complicated by diabetes mellitus.

Hepatol Res. 2019-5

[8]
Evaluation of the effects of dapagliflozin, a sodium-glucose co-transporter-2 inhibitor, on hepatic steatosis and fibrosis using transient elastography in patients with type 2 diabetes and non-alcoholic fatty liver disease.

Diabetes Obes Metab. 2018-10-2

[9]
Empagliflozin is associated with improvements in liver enzymes potentially consistent with reductions in liver fat: results from randomised trials including the EMPA-REG OUTCOME® trial.

Diabetologia. 2018-7-31

[10]
Effects of dapagliflozin and n-3 carboxylic acids on non-alcoholic fatty liver disease in people with type 2 diabetes: a double-blind randomised placebo-controlled study.

Diabetologia. 2018-7-3

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