Empagliflozin Treatment for Non-alcoholic Fatty Liver Disease in Type 2 Diabetes Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract
Empagliflozin, a sodium-glucose cotransporter-2 (SGLT2) inhibitor, has emerged as a promising therapeutic option for patients with concurrent type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD). This systematic review and meta-analysis evaluated the efficacy of empagliflozin on liver enzymes and metabolic parameters in this dual-pathology population. A comprehensive search was conducted across PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases from inception to July 2025. Randomized controlled trials (RCTs) comparing empagliflozin with placebo in adults with T2DM and NAFLD were included. Primary outcomes included changes in liver enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT)), while secondary outcomes comprised systolic blood pressure (SBP) and glycated hemoglobin (HbA1c) levels. Four studies met the inclusion criteria, encompassing 393 participants (206 empagliflozin, 187 control) with follow-up periods ranging from 20 to 24 weeks. Meta-analysis demonstrated significant reductions in ALT (mean difference (MD): -11.61; 95% confidence interval (CI): -19.18 to -4.04), AST (MD: -10.31; 95% CI: -15.41 to -5.21), and GGT levels (MD: -15.19; 95% CI: -18.13 to -12.25) with empagliflozin treatment compared to placebo. However, no statistically significant differences were observed for SBP (MD: -0.87; 95% CI: -7.93 to 6.20) or HbA1c (MD:…
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: 393 participants or records.
Read the paper
Related studies
- The Role of AMPK Activation for Cardioprotection in Doxorubicin-Induced Cardiotoxicity
- Hypoglycemic medicines in the treatment of Alzheimer’s disease: Pathophysiological links between AD and glucose metabolism
- Isorhamnetin Reduces Glucose Level, Inflammation, and Oxidative Stress in High-Fat Diet/Streptozotocin Diabetic Mice Model
- Modulating Sirtuin Biology and Nicotinamide Adenine Diphosphate Metabolism in Cardiovascular Disease—From Bench to Bedside
- Characterization of the SGLT2 Interaction Network and Its Regulation by SGLT2 Inhibitors: A Bioinformatic Analysis
- Early Treatment with Empagliflozin and GABA Improves β-Cell Mass and Glucose Tolerance in Streptozotocin-Treated Mice
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.