Non-alcoholic fatty liver disease (
NAFLD) is one of the main causes of
liver disease, specifically chronic
liver disease.
Type 2 diabetes (T2DM) is associated with the risk of
NAFLD given that patients usually have
insulin resistance as one of the observed complications with
NAFLD.
Hypoglycemic agents, including
sodium glucose cotransporter 2 (SGLT-2), have shown to improve
NAFLD. The objective of this study is to evaluate the effect of
SGLT-2 inhibitors on
NAFLD patients’ outcomes, whether they have T2DM or not. We conducted a comprehensive search using the PubMed and Ovid databases to identify published studies that addressed the use of
SGLT-2 inhibitors in
NAFLD patients. The outcomes assessed include changes in liver
enzymes,
lipid profiles, weight changes, the fibrosis-4-index (FIB4), and magnetic resonance imaging
proton density-based fat fraction (MRI-PDFF). Only clinical trials that met the quality measures were included in this review. Out of 382 potential studies, we included 16 clinical trials that discussed the use of
SGLT-2 inhibitors in
NAFLD patients. A total of 753 patients were enrolled in these trials. The majority of the trials reported positive effects of
SGLT-2 inhibitors on liver
enzymes;
alanine transaminase (ALT),
aspartate aminotransferase (AST), and gamma-glutamyl
transferase. All 10 trials that reported changes in body mass index (BMI) from baseline showed a statistically significant reduction with
SGLT-2 inhibitor use, while 11 studies reported a significant increase in
high density lipoprotein (HDL) levels, 3 studies reported a reduction in
triglycerides (TG) levels, and 2 studies showed a decrease in
low density lipoprotein (
LDL) levels. The available evidence shows that the use of
SGLT-2 inhibitors in
NAFLD is associated with positive outcomes on liver
enzymes,
lipid profiles, and BMI. Further studies with larger sample size and longer follow-up time are warranted.