Meta-analysis of the effects of sodium glucose cotransporter 2 inhibitors in non-alcoholic fatty liver disease patients with type 2 diabetes
The co-existence of type 2 diabetes (T2D) and non-alcoholic fatty liver disease (NAFLD) is very common. Delay in the treatment of these conditions can lead to serious complications. Sodium-glucose cotransporter 2 inhibitors (SGLT-2i) have shown to have a unique mode of action, that can be an effective strategy in the treatment of T2D and NAFLD. However, there is less evidence supporting the treatment with SGLT-2i. Sinha and colleagues conducted a trial published in the Journal of Gastroenterology and Hepatology under the title “Meta-analysis of the effects of sodium-glucose cotransporter 2 inhibitors in non-alcoholic fatty liver disease patients with type 2 diabetes”. The summary of the analysis can be studied below:
Objective:
To provide clarity on the effect of SGLT-2i in NAFLD with T2D.
Method:
This meta-analysis comprises of nine randomized controlled trials identified on a web-based search from the Cochrane Library, Embase, and PubMed. The Comprehensive Meta-Analysis Software version 3 was used to calculate the effect size.
Findings:
There was a decrease in hepatic inflammation as a significant improvement was observed in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels. Additionally, improvement in liver fat and visceral fat mass (VFM) was observed. Investigators confirmed that SGLT-2i has beneficial effects like weight loss and improvement of HbA1c in T2D patients with NAFLD. Findings don’t report any statistical significance in the reduction of TG levels in these patients.
Hence, in addition to lifestyle modification, SGLT-2i inhibitors can be used as an effective strategy in the treatment of T2D patients with NAFLD.
Limitation:
Analyzation of data using published effect size and not from individual-level pooled data could miss out on valuable patient-related outcome information. Authors acknowledge that heterogenous reporting affected data interpretation. Lastly, there was the absence of biopsy-proven improvements in hepatic architecture and function.
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