PMID- 37374340 OWN - NLM STAT- MEDLINE DCOM- 20230713 LR - 20230713 IS - 1648-9144 (Electronic) IS - 1010-660X (Print) IS - 1010-660X (Linking) VI - 59 IP - 6 DP - 2023 Jun 12 TI - The Effects of Sodium-Glucose Cotransporter 2-Inhibitors on Steatosis and Fibrosis in Patients with Non-Alcoholic Fatty Liver Disease or Steatohepatitis and Type 2 Diabetes: A Systematic Review of Randomized Controlled Trials. LID - 10.3390/medicina59061136 [doi] LID - 1136 AB - Type 2 Diabetes Mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD) are part of metabolic syndrome and share multiple causal associations. Both conditions have an alarmingly increasing incidence and lead to multiple complications, which have an impact on a variety of organs and systems, such as the kidneys, eyes, and nervous and cardiovascular systems, or may cause metabolic disruptions. Sodium-glucose cotransporter 2-inhibitors (SGLT2-i), as an antidiabetic class with well-established cardiovascular benefits, and its class members have also been studied for their presumed effects on steatosis and fibrosis improvement in patients with NAFLD or non-alcoholic steatohepatitis (NASH). The MEDLINE and Cochrane databases were searched for randomized controlled trials examining the efficacy of SGLT2-i on the treatment of NAFLD/NASH in patients with T2DM. Of the originally identified 179 articles, 21 articles were included for final data analysis. Dapagliflozin, empagliflozin, and canagliflozin are some of the most used and studied SGLT2-i agents which have proven efficacy in treating patients with NAFLD/NASH by addressing/targeting different pathophysiological targets/mechanisms: insulin sensitivity improvement, weight loss, especially visceral fat loss, glucotoxicity, and lipotoxicity improvement or even improvement of chronic inflammation. Despite the considerable variability in study duration, sample size, and diagnostic method, the SGLT2-i agents used resulted in improvements in non-invasive markers of steatosis or even fibrosis in patients with T2DM. This systematic review offers encouraging results that place the SGLT2-i class at the top of the therapeutic arsenal for patients diagnosed with T2DM and NAFLD/NASH. FAU - Bica, Ioana-Cristina AU - Bica IC AUID- ORCID: 0000-0002-8957-5980 AD - The Doctoral School of "Carol Davila", University of Medicine and Pharmacy, 020021 Bucharest, Romania. FAU - Stoica, Roxana Adriana AU - Stoica RA AUID- ORCID: 0000-0003-0085-6872 AD - The Department of Diabetes, Nutrition and Metabolic Diseases, "Carol Davila" University of Medicine and Pharmacy, 030167 Bucharest, Romania. FAU - Salmen, Teodor AU - Salmen T AUID- ORCID: 0000-0003-4548-7441 AD - The Doctoral School of "Carol Davila", University of Medicine and Pharmacy, 020021 Bucharest, Romania. FAU - Janez, Andrej AU - Janez A AUID- ORCID: 0000-0002-6594-5254 AD - The Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center, The Medical Faculty, The University of Ljubljana, 1000 Ljubljana, Slovenia. FAU - Volcansek, Spela AU - Volcansek S AUID- ORCID: 0000-0003-2354-6279 AD - The Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center, The Medical Faculty, The University of Ljubljana, 1000 Ljubljana, Slovenia. FAU - Popovic, Djordje AU - Popovic D AD - The Clinic for Endocrinology, Diabetes and Metabolic Disorders, The Clinical Centre of Vojvodina, The Medical Faculty, The University of Novi Sad, 21137 Novi Sad, Serbia. FAU - Muzurovic, Emir AU - Muzurovic E AUID- ORCID: 0000-0003-2022-3298 AD - The Department of Internal Medicine, The Endocrinology Section, The Clinical Center of Montenegro, The Faculty of Medicine, The University of Montenegro, 81000 Podgorica, Montenegro. FAU - Rizzo, Manfredi AU - Rizzo M AUID- ORCID: 0000-0002-9549-8504 AD - The Department of Diabetes, Nutrition and Metabolic Diseases, "Carol Davila" University of Medicine and Pharmacy, 030167 Bucharest, Romania. AD - School of Medicine, Promise Department, University of Palermo, 90100 Palermo, Italy. FAU - Stoian, Anca Pantea AU - Stoian AP AUID- ORCID: 0000-0003-0555-526X AD - The Department of Diabetes, Nutrition and Metabolic Diseases, "Carol Davila" University of Medicine and Pharmacy, 030167 Bucharest, Romania. LA - eng PT - Journal Article PT - Systematic Review DEP - 20230612 PL - Switzerland TA - Medicina (Kaunas) JT - Medicina (Kaunas, Lithuania) JID - 9425208 RN - 0SAC974Z85 (Canagliflozin) RN - 1ULL0QJ8UC (dapagliflozin) RN - HDC1R2M35U (empagliflozin) RN - 0 (Sodium-Glucose Transporter 2 Inhibitors) SB - IM MH - Canagliflozin/therapeutic use MH - *Diabetes Mellitus, Type 2/complications/drug therapy MH - *Fatty Liver/complications/drug therapy MH - *Non-alcoholic Fatty Liver Disease/drug therapy MH - Randomized Controlled Trials as Topic MH - *Sodium-Glucose Transporter 2 Inhibitors/therapeutic use MH - Humans PMC - PMC10301940 OTO - NOTNLM OT - diabetes OT - fibrosis OT - non-alcoholic fatty liver disease OT - non-alcoholic steatohepatitis OT - sodium-glucose cotransporter 2-inhibitors OT - steatosis COIS- The authors declare that there is no conflict of interest related to the present article. EDAT- 2023/06/28 06:42 MHDA- 2023/06/29 06:43 PMCR- 2023/06/12 CRDT- 2023/06/28 01:26 PHST- 2023/04/05 00:00 [received] PHST- 2023/06/08 00:00 [revised] PHST- 2023/06/08 00:00 [accepted] PHST- 2023/06/29 06:43 [medline] PHST- 2023/06/28 06:42 [pubmed] PHST- 2023/06/28 01:26 [entrez] PHST- 2023/06/12 00:00 [pmc-release] AID - medicina59061136 [pii] AID - medicina-59-01136 [pii] AID - 10.3390/medicina59061136 [doi] PST - epublish SO - Medicina (Kaunas). 2023 Jun 12;59(6):1136. doi: 10.3390/medicina59061136.