Therapeutic outcome of dapagliflozin in patients with type 2 diabetes and non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials

Introduction: The efficacy of dapagliflozin remains controversial for patients with type 2 diabetes and non-alcoholic fatty liver disease. We conduct this meta-analysis to explore the influence of dapagliflozin versus placebo on the treatment efficacy of type 2 diabetes complicated with non-alcoholic fatty liver disease.Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through November 2021 for randomized controlled trials (RCTs) assessing the efficacy of dapagliflozin versus placebo for type 2 diabetes compli-cated with non-alcoholic fatty liver disease. This meta-analysis is performed using the random-effect model.Results: Four RCTs are included in the meta-analysis. Overall, compared with patients with type 2 diabetes and non-alcohol-ic fatty liver disease, dapagliflozin treatment is associated with significantly reduced alanine aminotransferase (ALT, standard mean difference [SMD]=-1.27; 95% confidence interval [CI]span style="font-family: 'Times New Roman'">=-1.60 to-0.95; P<0.00001), aspartate-aminotransferase (AST, SMD=-1.37; 95% CI=-2.08 to-0.65; P=0.0002), fasting glucose (SMD=-0.78; 95% CI=-1.28 to-0.27; P=0.003) and HbA1c (SMD=-0.77; 95% CI=-1.21 to-0.34; P=0.0005), but demonstrated no obvious influence on homeostatic Model Assessment of Insulin Resistance (HOMA-IR, SMD=-0.36; 95% CI=-0.86 to 0.14; P=0.16). Conclusions: Dapagliflozin benefits to improve hepatic function and glucose control in patients with type 2 diabetes and non-alcoholic fatty liver disease, as evidenced by the reduction in ALT, AST, fasting glucose and HbA1c.