8149 The Effect of SGLT2 Inhibitors On NAFLD In Patients With Type 2 Diabetes: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials

Abstract Disclosure: F.A. Kelly: None. M.C. Souza: None. A.M. De Almeida: None. I.B. Andrade: None. V. Morbach: None. E. Pasqualotto: None. M.B. Jardine: None. R.Y. Ura Sudo: None. P.G. Lima: None. M.G. Leite: None. M.S. Barros: None. J.C. Cardoso: None. I.P. da Silva: None. F.A. Moraes: None. F.D. Pessôa: None. A.D. Lôbo: None. L.M. Lopes: None. M.P. Lima: None. Type 2 diabetes (T2D) globally afflicts millions, entailing complications beyond hyperglycemia. Ectopic fat, the perilous accumulation of adipose tissue infiltrating vital organs, fuels a harmful cycle of insulin resistance and inflammation. Managing ectopic fat in T2D poses a significant challenge, compounded by non-alcoholic fatty liver disease (NAFLD) comorbidities that reduce life expectancy. Conventional interventions often inadequately address this issue. While current treatments predominantly target blood sugar, ectopic fat persists, contributing to complications like cardiovascular disease, fatty liver disease, and cancer. Sodium-glucose cotransporter 2 inhibitors (SGLT2i), recognized for lowering blood sugar, have garnered interest for their potential impact on ectopic fat. These medications induce metabolic benefits beyond glycemic control by promoting urinary glucose excretion, presenting a promising avenue for addressing the intricate challenges of T2D.This meta-analysis aims to evaluate the potential of SGLT2 inhibitors, established glucose-lowering drugs in T2D, to reduce ectopic fat accumulation and mitigate its associated risks.PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched for randomized controlled trials (RCT) comparing the use of SGLT2i versus other therapies in patients with T2D and NAFLD. A random-effects model was used to calculate the mean differences (MD) with 95% confidence intervals (CI). Statistical analysis was performed in R software 4.3.1. A total of 9 RCTs comprising 558 patients were included, of whom 252 were randomized to SGLT2i therapy, 101 to pioglitazone, 166 to placebo, and 39 to other treatments. The mean follow-up was 21 weeks. In the pooled analysis, SGLT2i therapy was associated with a significant reduction in body weight (MD -1.81 kg; 95% CI -2.74,-0.88; p<0.001), alanine aminotransferase (ALT) (MD -4.29 U/L; 95% CI -8.35,-0.22; p=0.038), visceral adipose tissue (VAT) (MD -10.37 cm²; 95% CI -12.68,-8.06, p<0.001); and subcutaneous adipose tissue (SCAT) (MD -9.52 cm²; 95% CI -11.69, -7.34, p<0.001). There were no significant differences for body mass index (MD -0.14 kg/m2; 95% CI -0.94, 0.64; p=0.716), aspartate aminotransaminase (MD 1.18 U/L; 95% CI -3.96,6.34; p=0.651), controlled attenuation parameter (MD -2.44 dB/m; 95% CI -20.41,15.51; p=0.789), gamma-glutamyl transpeptidase (MD -1.10 U/L; 95% CI -15.73,13.52; p=0.882), and HbA1c (MD -0.13%; 95% CI -0.44,0.17; p=0.384).In this meta-analysis of RCTs of patients with T2D and NAFLD, the use of SGLT2i showed a significant reduction in body weight, ALT, SCAT, and VAT. Presentation: 6/3/2024