Effects of sodium-glucose co-transporter 2 inhibitors on liver fibrosis in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus: An updated meta-analysis of randomized controlled trials

Zijie Jin; Yan Yuan; Chen Zheng; Shijian Liu; Hongbo Weng

doi:10.1016/j.jdiacomp.2023.108558

Effects of sodium-glucose co-transporter 2 inhibitors on liver fibrosis in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus: An updated meta-analysis of randomized controlled trials

J Diabetes Complications. 2023 Aug;37(8):108558. doi: 10.1016/j.jdiacomp.2023.108558. Epub 2023 Jul 19.

Authors

Zijie Jin¹, Yan Yuan², Chen Zheng², Shijian Liu³, Hongbo Weng⁴

Affiliations

¹ Fudan University School of Pharmacy, Shanghai 201203, China. Electronic address: zijiejin21@m.fudan.edu.cn.
² Fudan University School of Pharmacy, Shanghai 201203, China.
³ Department of Clinical Epidemiology and Biostatistics, Child Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China. Electronic address: liushijian@scmc.com.cn.
⁴ Fudan University School of Pharmacy, Shanghai 201203, China. Electronic address: hbweng@fudan.edu.cn.

PMID: 37499274
DOI: 10.1016/j.jdiacomp.2023.108558

Abstract

Background and aim: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) has been verified to improve Non-alcoholic fatty liver disease (NAFLD) in previous clinical practice. We mainly aim to investigate the effects of SGLT2i on liver fibrosis in NAFLD patients with type 2 diabetes mellitus (T2DM).

Methods: We conducted a comprehensive literature search utilizing the databases PubMed, Embase, Web of Science, and Cochrane Library, and extracted continuous data in the form of mean and standard deviation of the difference before and after treatment. RevMan 5.3 software was used to chart the pooled forest plot and perform heterogeneity, sensitivity and subgroup analysis. This study is conducted under the protocol registered with the Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY protocol 4946, INPLASY202360058).

Results: A total of 16 articles involving 699 patients were included. Indicators of liver fibrosis, containing Liver Stiffness Measurement (LSM), Controlled Attenuation Parameter (CAP), Serum ferritin, Serum type 4 collagen 7s, and FIB-4 index, were found to be considerably reduced by SGLT2i medication and subgroup analysis manifested pronounced dose-dependence. Additionally, SGLT2i therapy decreased BMI, lipid buildup and insulin resistance.

Conclusions: SGLT2 inhibitors significantly ameliorated liver fibrosis and liver fat content, improved body conditions and insulin resistance, demonstrating that SGLT2i might reduce the risk of the progression of liver fibrosis and have a positive effect on NAFLD patients with T2DM.

Keywords: Liver fibrosis; NAFLD; NASH; SGLT2 inhibitors; T2DM.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Diabetes Mellitus, Type 2* / complications
Diabetes Mellitus, Type 2* / drug therapy
Humans
Insulin Resistance*
Liver Cirrhosis / complications
Liver Cirrhosis / drug therapy
Non-alcoholic Fatty Liver Disease* / complications
Non-alcoholic Fatty Liver Disease* / drug therapy
Randomized Controlled Trials as Topic
Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use

Substances

Sodium-Glucose Transporter 2 Inhibitors