Meta-Analysis
Copyright ©The Author(s) 2021.
World J Diabetes. Jan 15, 2021; 12(1): 84-97
Published online Jan 15, 2021. doi: 10.4239/wjd.v12.i1.84
Table 1 Summary of included studies
Ref.
Study duration
Population
Assessment of NAFLD
Intervention
No. of participants
Alam et al[18], 201852 wkNAFLDBiopsySitagliptin 100 mg QD + lifestyle modification20
Lifestyle modification20
Cui et al[19], 201724 wkNAFLD with prediabetes or early diabetesMRISitagliptin 100 mg QD25
PBO25
Hussain et al[20], 201612 wkNAFLD + dyslipidemiaUltrasoundVildagliptin 50 mg Bid29
PBO29
Macauley et al[21], 20156 moT2DM with hepatic steatosisImaging (CT or ultrasound)Vildagliptin 50 mg Bid22
PBO22
Joy et al[22], 201724 wkNASHBiopsySitagliptin 100 mg QD6
PBO6
Li et al[23], 201924 wkT2DM with NAFLDImaging or biopsySaxagliptin 5 mg QD31
Glimepiride 2 mg QD33
Glimepiride 2 mg QD + polyenephosphatidylcholine 456 mg TID31
Yan et al[24], 201926 wkT2DM with NAFLDMRILiraglutide 1.8 mg + metformin24
Sitagliptin + metformin27
Glargine 0.2 IU/Kg/d + metformin24
Armstrong et al[25], 201648 wkT2DM with NASHBiopsyLiraglutide 1.8 mg QD26
PBO26
Cusi et al[26], 20186 moT2DM with NAFLD/NASHLaboratory liver testsDuraglutide 1.5 mg QW971
PBO528
Fan et al[27], 201312 wkT2DM with NAFLDUltrasoundExenatide49
Metformin68
Feng et al[28], 201724 wkT2DM with NAFLDUltrasoundMetformin 1000 mg Bid29
Gliclazide 120 mg/d29
Liraglutide 1.8 mg QD29
Khoo et al[29], 201726 wkNAFLDMRILiraglutide 3.0 mg QD12
Diet and exercise12
Shao et al[30], 201412 wkT2DM with NAFLDUltrasoundExenatide 10 μg bid + glargine30
Intensive insulin therapy30
Tian et al[31], 201812 wkT2DM with NAFLDUltrasoundLiraglutide 0.6-1.2 mg QD52
Metformin 1000-1500 mg/d75
Eriksson et al[32], 201812 wkT2DM with NAFLDMRIDapagliflozin 10 mg QD21
PBO21
Dapagliflozin 10 mg QD + OM-3CA22
OM-3CA 4 g20
Ito et al[33], 201724 wkT2DM with NAFLDClinical laboratorytests or imagingIpragliflozin 50 mg QD32
Pioglitazone 15–30 mg QD34
Kuchay et al[34], 201820 wkT2DM with NAFLDMRIEmpagliflozin 10 mg QD22
Control20
Shibuya et al[35], 20186 moT2DM with NAFLDImaging (CT or ultrasound)Luseogliflozin 2.5 mg QD16
Metformin 1500 mg QD16
Shimizu et al[36], 201824 wkT2DM with NAFLDTransient elastographyDapagliflozin 5 mg QD33
Control24
Table 2 Comparison of body weight and body mass index changes from baseline in different treatment groups

Studies
Participants
WMD
95%CI
P value
Body weight change
DPP-4 inhibitors4140/138-1.20 -1.44-0.95< 0.0001
GLP-1 RAs81222/821-3.61-5.74-1.480.0009
SGLT2 inhibitors5146/135-2.53 -3.35-1.71< 0.0001
BMI change
DPP-4 inhibitors5144/146-0.59 -1.800.610.33
GLP-1 RAs7251/293-1.46-2.23-0.690.0002
SGLT2 inhibitors4114/101-1.72-2.68-0.750.0005
Table 3 Comparison of hemoglobin A1c change from baseline in different treatment groups

Studies
Participants
WMD
95%CI
P value
HbA1c change
DPP-4 inhibitors6166/166-0.42 -0.58-0.25< 0.0001
GLP-1 RAs71210/809-0.29-0.850.260.30
SGLT2 inhibitors5146/135-0.36 -0.800.080.11
HbA1c change (placebo-controlled studies only)
DPP-4 inhibitors5102/102-0.38-0.71-0.050.02
GLP-1 RAs31009/566-0.88-1.56-0.190.01
SGLT2 inhibitors121/21-0.50-0.84-0.160.004
Table 4 Comparison of magnetic resonance imaging proton density fat fraction and visceral fat area change from baseline in different treatment groups

Studies
Participants
WMD
95%CI
P value
MRI-PDFF change
DPP-4 inhibitors252/49-2.31 -4.920.290.08
GLP-1 RAs124/24-3.20-5.98-0.420.02
SGLT2 inhibitors265/61-1.18 -2.380.030.06
VFA change
DPP-4 inhibitors127/24-23.10 -38.84-7.360.004
GLP-1 RAs124/24-30.40-46.86-13.940.0003
SGLT2 inhibitors248/50-23.48 -25.85-21.12< 0.0001
Table 5 Meta-regression analyses of association between weight change difference and difference of alanine aminotransferase, aspartate aminotransferase, magnetic resonance imaging proton density fat fraction, and visceral fat area between antidiabetes drugs and controls (ß coefficient value, P value, and 95%CI are shown)

ß
P value
95%CI
ALT0.0640.267-0.053-0.181
AST0.0200.735-0.104-0.144
MRI-PDFF0.3080.701-2.678-3.294
VFA1.7760.343-11.723-15.275