Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) has been found to be a chronic and precarious metabolic complication from diabetes mellitus. Due to the limitation of treatment options for NAFLD, we postulated that SGLT2 inhibitors would have a potential benefit for NAFLD. None of the previous studies have comprehensively addressed multiple different classes of SGLT2 inhibitor in type 2 DM individuals with NAFLD. We conducted the first meta-analysis investigating the impact of SGLT2 inhibitors on liver function test in type2DM and NAFLD. Methods: We comprehensively searched the databases of MEDLINE, EMBASE, and Cochrane databases. The inclusion criteria were published randomized control trials (RCT), prospective studies, and retrospective studies comparing SGLT2 inhibitors to placebo or controls in NAFLD and type 2 DM individuals. The primary outcome was the differences in the change of ALT and AST. We also examined the changes of NAFLD risk factors including body composition, lipid profile, HbA1C as secondary outcomes. Pooled odds ratio and 95% confidence interval were calculated using a random-effects model (generic inverse variance method). The between-study heterogeneity of effect size was quantified using the Q statistic and I. Results: Eight RCTs, one prospective study, and one retrospective study with 4698 patients were included in the analysis. There was a statistically significant reduction of AST (MD=-2.09, 95% CI:-3.65to-0.52) and ALT (MD=-6.02, 95% CI: -8.35to-3.70) favoring SGLT2 inhibitor groups. Conclusion: SGLT2 inhibitor groups were shown to have a statistically significant reduction of ALT and AST compared to placebo or control groups. SGLT2 inhibitor might be considered as a conjunctive treatment for NAFLD in type2DM individuals. Further studies regarding the optimal dosage and duration of SGLT2 inhibitors are helpful to assess potentially favorable effects in type 2 DM individuals and NAFLD. Disclosure S. Thavaraputta: None. K. Wirunsawanya: None. P. Laoveeravat: None.
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