Effects of sodium-glucose co-transporter 2 inhibitors on liver parameters and steatosis: A meta-analysis of randomized clinical trials

Autores da FMUP

• Marta Borges Canha

  Autor

• Madalena Pereira De Sousa Von Hafe Pérez

  Autor

• João Sérgio De Lima Soares Neves

  Autor

• Catarina Afonso Couto E Vale

  Autor

• Davide Maurício Costa Carvalho

  Autor

• Joaquim Adelino Correia Ferreira Leite Moreira

  Autor

Participantes de fora da FMUP

• Coelho, FD
• Leite, AR

Unidades de investigação

• Cirurgia e Fisiologia

• Medicina

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Aims Non-alcoholic fatty liver disease (NAFLD) is the most common form of chronic liver disease in Western countries and a common comorbidity with type 2 diabetes (T2D). It lacks effective pharmacotherapy. We aimed to summarize the evidence on the effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors on liver structure and function. Materials and methods Meta-analysis of randomized clinical trials in PubMed, Web of Science and from their inception to April 2019. Trials evaluating liver function and/or structure and comparing SGLT2 inhibitors with placebo or other oral antidiabetic drugs in patients with T2D were included. Twenty studies (from 3033) were included. A total of 1950 patients with T2D, with or without NAFLD, were treated with SGLT2 inhibitors for at least 8 weeks, and 1900 patients were used as controls. Independent extraction was carried out by two observers. This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Results SGLT2 inhibitors induced a significant decrease in serum alanine (-7.43U/L, [95%CI -12.14, -2.71],p< 0.01), in aspartate aminotransferases (-2.83U/L, [-4.71, -0.95],p< 0.01), as well as in gamma glutamyl transferase (-8.21U/L, [-9.52, -6.91],p< 0.01), and an increase in total plasma bilirubin (8.19% [0.79, 15.59],p< 0.01), comparing with placebo or other oral antidiabetic drugs. SGLT2 inhibitors treatment was associated with a decrease in liver steatosis (-3.39% [-6.01, -0.77],p< 0.0.1). Conclusions Treatment with SGLT2 inhibitors improves liver structure and function in patients with T2D. This meta-analysis suggests that SGLT2 inhibitors are a promising pharmacological approach for treatment of NAFLD.

© 2020 John Wiley & Sons Ltd.

Keywords

• liver; metanalysis; NAFLD; SGLT2 inhibitors