Results

Five clinical trials were included. One study reported significant improvements in the controlled attenuation parameter 314.6±61.0 dB/m to 290.3±72.7 dB/m (p= 0.04) in the SGLT2i group measured by transient elastography. In patients with significant fibrosis, dapagliflozin treatment significantly decreased the liver stiffness measurement from 14.7±5.7 kPa at baseline to 11.0±7.3 kPa after 24 weeks (p= 0.02). One study reported a significant decrease in liver fat content 16.2% to 11.3%(p< 0.001) in the SGLT2i group compared to the control (p< 0.001). Three studies reported significant improvement in the liver-to-spleen ratio in the SGLT2i group after treatment 0.96 (0.86-1.07) to 1.07 (0.98-1.14), p< 0.01, 0.80±0.24 to 1.00±0.18, p< 0.001, and 0.91 (0.64-1.04) to 1.03 (0.80-1.20), p< 0.001 respectively. All studies reported a significant decrease in alanine aminotransferase with SGLT2i.

Conclusions

SGLT2i is associated with positive effects on hepatic steatosis measured by non-invasive modalities. Further studies are needed to confirm the impact of SGLT2i on hepatic fibrosis and steatosis.