8149 The Effect of SGLT2 Inhibitors On NAFLD In Patients With Type 2 Diabetes: A Systematic Review And Meta-Analysis Of Randomized Controlled Trials
Bibliographic record
Abstract
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
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.042 | 0.022 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".