Meta-analysis of the effect of SGLT2 inhibitors on hepatic fibrosis in patients with T2DM complicated with NAFLD.

OBJECTIVE This study aimed to analyze the effects of SGLT2 inhibitors on the indexes of liver fibrosis in patients with T2DM complicated with NAFLD, and also to observe the effects on liver enzymes and liver fat. MATERIAL AND METHODS This meta-analysis was performed using RevMan 5.3 statistical software. RESULTS SGLT2 inhibitors could significantly reduce the level of hepatic fibrosis index: fibrosis-4 (FIB-4) (MD: 0.25, 95% CI: -0.39 to -0.11, P = 0.0007); serum type Ⅳ collagen 7s (MD: 0.32, 95% CI: -0.59 to -0.04, P = 0.02); and ferritin (MD: 26.7, 95% CI: 50.64, 2.76, P = 0.03). SGLT2 inhibitors could significantly reduce the level of liver enzymes: alanine aminotransferase (MD: 3.49, 95% CI: -5.1 to 1.58, P < 0.0001); aspartate aminotransferase (MD: 3.64, 95% CI: -5.10 to -2.18, P < 0.00001); and glutamate aminotransferase (MD: 7.13, 95% CI: -12.95 to -1.32, P = 0.02). SGLT2 inhibitors could significantly reduce the level of liver fat: liver-spleen attenuation ratio (MD: 0.16, 95% CI: 0.10-0.22, P < 0.00001); magnetic resonance imaging proton density fat fraction (MD: 1.97, 95% CI: -3.49 to -0.45, P = 0.01); liver controlled attenuation parameter (MD: 0.29, 95% CI: -26.95 to -13.64, P < 0.00001); liver fat score (MD: 0.55, 95% CI 1.04 to -0.05, P = 0.03); and liver fat index (MD: 11.21, 95% CI: -16.53 to -5.89, P < 0.0001). CONCLUSION SGLT2 inhibitors could improve liver fibrosis, liver enzymes, liver fat, and metabolic indexes in patients with T2DM complicated with NAFLD. This article is protected by copyright. All rights reserved.