Impact of SGLT2 inhibitors on nonalcoholic fatty liver disease in T2DM

  • Xing B & al.
  • J Diabetes Investig
  • 21 Feb 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with type 2 diabetes mellitus (T2DM), sodium-glucose co-transporter 2 (SGLT2) inhibitors use decreased alanine aminotransferase [ALT]) level and liver fat, along with the effect of weight loss.

Why this matters

  • Nonalcoholic fatty liver disease is common in patients with T2DM.
  • SGLT2 inhibitors may become a new option for the treatment of T2DM with NAFLD.

Study design

  • 6 randomised controlled trials (RCTs; n=309) met eligibility criteria after a search across electronic databases.
  • Primary outcomes: change of liver enzymes (ALT and aspartate aminotransferase [AST]) and magnetic resonance imaging-proton density fat fraction (MRI-PDFF).
  • Funding: None.

Key results

  • SGLT2 inhibitors significantly reduced ALT level (weighted mean difference [WMD], −11.05 [95% CI, −19.85 to −2.25] IU/L; P=.01; I2=73%) and MRI-PDFF (WMD, −2.07%; 95% CI, −3.86 to 0.28%; P=.02).
  • SGLT2 inhibitors were not associated with a reduction in AST (WMD, −1.11 [95% Cl, −2.39 to 0.17] IU/L; P=.09).
  • SGLT2 inhibitors were linked to a reduction in body weight (WMD, −1.62 [95% Cl, −2.02 to -1.23] kg) and visceral fat area (WMD, −19.98 [95% CI, −27.18 to −12.79] cm2; P<.00001 for both>

Limitations

  • Heterogeneity among studies.
  • Small sample size and short follow-up.