PMID- 34239714
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220424
IS  - 1999-768X (Print)
IS  - 2070-5204 (Electronic)
IS  - 1999-768X (Linking)
VI  - 36
IP  - 3
DP  - 2021 May
TI  - Effect of SGLT-2 Inhibitors on Non-alcoholic Fatty Liver Disease among Patients 
      with Type 2 Diabetes Mellitus: Systematic Review with Meta-analysis and Trial 
      Sequential Analysis of Randomized Clinical Trials.
PG  - e273
LID - 10.5001/omj.2021.62 [doi]
AB  - OBJECTIVES: Non-alcoholic fatty liver disease (NAFLD) or non-alcoholic 
      steatohepatitis (NASH) is a common problem associated with obesity and type 2 
      diabetes mellitus (T2DM). There have been anecdotal reports of the efficacy of 
      sodium-glucose cotransporter 2 inhibitors (SGLT2Is) in improving liver function 
      parameters in those with concomitant T2DM and NAFLD/NASH. We sought to 
      systematically evaluate the evidence of SGLT2Is in improving liver function 
      parameters in T2DM patients with NAFLD, considering the risks of random error 
      based on trial sequential analysis (TSA). We also performed a meta-analysis based 
      on a random-effects model. METHODS: A systematic literature search was performed 
      using the Medline, Cochrane, and Embase databases from inception to 20 October 
      2018. Primary outcome for meta-analyses was the changes in hepatic enzyme levels 
      (alanine transaminase, aspartate transaminase, and gamma-glutamyl 
      transpeptidase). We also performed a meta-analysis on changes in insulin 
      resistance, glycemic, and lipid parameters using SGLT2Is as a secondary 
      objective. RESULTS: Eight eligible randomized controlled studies were eligible 
      for analysis. Meta-analysis showed the efficacy of two SLT2Is, dapagliflozin, and 
      canagliflozin in reducing these enzymes level. TSA showed that canagliflozin 
      significantly reduced the gamma-glutamyl transpeptidase level by weighted mean 
      difference (-5.474, 95% confidence interval (CI): -6.289??-4.659) compared to 
      others comparators, and the evidence is conclusive. Dapagliflozin also had a 
      statistically significant reduction in glycated hemoglobin, which is a parameter 
      of glycemic control and homeostatic model assessment for insulin sensitivity 
      (HOMA-IR), which is a parameter of insulin sensitivity by a weight mean 
      difference, -0.732 (95% CI: -1.087??-0.378) and -0.804 (95% CI: -1.336??0.272), 
      respectively. CONCLUSIONS: This study indicated that canagliflozin effectively 
      improves liver function parameters among patients with diabetes, while 
      dapagliflozin is more effective in improving glycemic indices and insulin 
      sensitivity.
CI  - The OMJ is Published Bimonthly and Copyrighted 2021 by the OMSB.
FAU - Lee, Kai Wei
AU  - Lee KW
AD  - Department of Family Medicine, Faculty of Medicine and Health Sciences, 
      Universiti Putra Malaysia, Selangor, Malaysia.
FAU - Devaraj, Navin Kumar
AU  - Devaraj NK
AD  - Department of Family Medicine, Faculty of Medicine and Health Sciences, 
      Universiti Putra Malaysia, Selangor, Malaysia.
AD  - Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, 
      Selangor, Malaysia.
FAU - Ching, Siew Mooi
AU  - Ching SM
AD  - Department of Family Medicine, Faculty of Medicine and Health Sciences, 
      Universiti Putra Malaysia, Selangor, Malaysia.
AD  - Malaysian Research Institute on Ageing (MyAgeing), Universiti Putra Malaysia, 
      Selangor, Malaysia.
FAU - Veettil, Sajesh K
AU  - Veettil SK
AD  - School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia.
FAU - Hoo, Fan Kee
AU  - Hoo FK
AD  - Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra 
      Malaysia, Selangor, Malaysia.
FAU - Deuraseh, Inas
AU  - Deuraseh I
AD  - Department of Family Medicine, Faculty of Medicine and Health Sciences, 
      Universiti Putra Malaysia, Selangor, Malaysia.
FAU - Soo, Man Jun
AU  - Soo MJ
AD  - Department of Family Medicine, Faculty of Medicine and Health Sciences, 
      Universiti Putra Malaysia, Selangor, Malaysia.
LA  - eng
PT  - Journal Article
DEP - 20210531
PL  - Oman
TA  - Oman Med J
JT  - Oman medical journal
JID - 101526350
PMC - PMC8246653
OTO - NOTNLM
OT  - Canagliflozin
OT  - Non-alcoholic Fatty Liver Disease
OT  - Sodium-Glucose Transporter 2 Inhibitors
EDAT- 2021/07/10 06:00
MHDA- 2021/07/10 06:01
PMCR- 2021/05/31
CRDT- 2021/07/09 06:58
PHST- 2020/06/08 00:00 [received]
PHST- 2020/09/06 00:00 [accepted]
PHST- 2021/07/09 06:58 [entrez]
PHST- 2021/07/10 06:00 [pubmed]
PHST- 2021/07/10 06:01 [medline]
PHST- 2021/05/31 00:00 [pmc-release]
AID - OMJ-36-03-2000111 [pii]
AID - 10.5001/omj.2021.62 [doi]
PST - epublish
SO  - Oman Med J. 2021 May 31;36(3):e273. doi: 10.5001/omj.2021.62. eCollection 2021 
      May.