Efficacy of Empagliflozin on Liver Enzymes, Lipid Profile and BMI in Patients With Metabolic Dysfunction–Associated Steatotic Liver Disease ( MASLD ): A Systematic Review and Meta‐Analysis
Abstract
ABSTRACT Background Metabolic dysfunction‐associated steatotic liver disease (MASLD) is increasingly prevalent and associated with obesity and dyslipidemia, yet effective pharmacological interventions remain limited. Empagliflozin has shown potential benefits in MASLD, although evidence remains limited. This systematic review and meta‐analysis assesses the efficacy of empagliflozin in patients with MASLD, both diabetic and non‐diabetic. Methods An advanced database search was conducted up to June 1st, 2026, to identify eligible randomized controlled trials (RCTs). The relevant data were extracted from selected studies. Pooled effect sizes were calculated as weighted mean differences (WMDs) with 95% confidence intervals (CIs) using a random‐effects model. Results Seven RCTs comprising 591 participants were included. Empagliflozin significantly improved liver enzyme profiles. Specifically, it reduced alanine aminotransferase (ALT) (WMD: −12.24 IU/L; p = 0.037), aspartate aminotransferase (AST) (WMD: −9.51 IU/L; p = 0.048), and gamma‐glutamyl transferase (GGT) (WMD: −14.92 IU/L; p = 0.023). Reductions in alkaline phosphatase (ALP) were observed but did not reach statistical significance (WMD: −26.28 IU/L; p = 0.292). Although substantial heterogeneity was observed for several liver enzyme outcomes. Empagliflozin had no significant effect on lipid parameters, including triglycerides (TG), total cholesterol (TC), low‐density and high‐density lipoprotein cholesterols (LDL‐C,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 591 participants or records.
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