Comparative efficacy of sodium-glucose transporter 2 inhibitors on lipid profiles in nonalcoholic fatty liver disease (NAFLD): a comprehensive Bayesian network meta-analysis
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is a global health concern associated with dyslipidemia, obesity, and type 2 diabetes mellitus (T2DM), necessitating effective therapeutic strategies. Sodium-glucose transporter 2 (SGLT-2) inhibitors have shown promise in improving metabolic parameters, but their comparative efficacy in NAFLD remains unclear.
Methods: We systematically searched PubMed, Cochrane Library, Scopus, and Embase for randomized controlled trials (RCTs) up to 31 December 2024, involving NAFLD patients treated with SGLT-2 inhibitors versus placebo or standard treatments. Outcomes included changes in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol, triglycerides, BMI, and HbA1c. A Bayesian NMA was performed using a random-effects model, with mean differences (MD) and 95% credible intervals (CrI) reported. Treatments were ranked using Surface Under the Cumulative Ranking Curve (SUCRA) scores.
Results: We evaluated and compared the efficacy of SGLT-2 inhibitors in improving lipid profiles (LDL-C, HDL-C, total cholesterol, and triglycerides), BMI, and HbA1c in patients with NAFLD. Eleven RCTs involving 805 patients were included. Empagliflozin achieved the greatest LDL-C reduction (MD: -8.07 mg/dL, 95% CrI: -25.92 to 1.41; SUCRA: 95.38%), total cholesterol reduction (MD: -15.08 mg/dL, 95% CrI: -58.87 to 5.38; SUCRA: 94.32%), and HbA1c reduction (MD: -0.69%, 95% CrI: -1.52 to -0.06; SUCRA:…
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: 805 participants or records.
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