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Empagliflozin for liver and lipid profile in metabolic dysfunction-associated fatty liver disease: a meta-analysis

Kevin Fernando Suhardi, Jonathan Christianto Sutadji, Agustina Rajendra Putri, Ghina Tsamara, Icha Farihah Deniyati Faratisha, Aqsha Tiara Viazelda, Soebagijo Adi Soeslistijo

Medical Journal of Indonesia, 2025

636 participants · 1 citation

Abstract

BACKGROUND Metabolic dysfunction-associated fatty liver disease (MAFLD) is a common chronic liver condition often associated with obesity and diabetes. Empagliflozin, a sodium-glucose cotransporter 2 inhibitor, is an antidiabetic medication that improves glycemic control, insulin resistance, and body weight. This study aimed to examine the efficacy of empagliflozin in adults with MAFLD.

METHODS A comprehensive literature search was performed using the PubMed, ScienceDirect, Cochrane Library, Scopus, and Wiley Online Library databases. Randomized controlled trials assessing liver function, lipid profile, metabolic profile, and body composition were included. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated using random-effects models, and study quality was assessed using the Cochrane Risk of Bias Tool for Randomized Trials.

RESULTS 6 RCTs with a total of 636 participants were analyzed. Empagliflozin significantly reduced alanine aminotransferase levels (WMD: –6.65 IU/l, 95% CI: –13.02 to –0.28; p = 0.04) and gamma-glutamyl transferase levels (WMD: −10.60 IU/l, 95% CI: −29.05 to −7.68; p<0.00001). A non-significant reduction in aspartate aminotransferase was observed (WMD: –4.69 IU/l, 95% CI: –9.89 to 0.51; p = 0.08). Empagliflozin significantly improved low-density lipoprotein cholesterol (p = 0.02) and total cholesterol (p = 0.05) levels but did not significantly affect triglycerides, high-density lipoprotein cholesterol, metabolic…

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: 636 participants or records.

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