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Meta-Analysis
. 2024 Jul;26(7):2706-2721.
doi: 10.1111/dom.15586. Epub 2024 Apr 11.

The effect of sodium-glucose cotransporter-2 inhibitors on inflammatory biomarkers: A meta-analysis of randomized controlled trials

Leonardo Buttice  1 , Maryam Ghani  1 , Janahan Suthakar  1 , Sathyan Gnanalingham  1 , Elliott Carande  2   3 , Brett W C Kennedy  4 , Alex Pitcher  4 , James H P Gamble  4 , Mahmood Ahmad  1 , Andrew Lewis  4   5 , Peter Jüni  6 , Oliver J Rider  4   5 , Jeffrey W Stephens  3   7 , Jonathan J H Bray  1   3   4
Affiliations
Meta-Analysis

The effect of sodium-glucose cotransporter-2 inhibitors on inflammatory biomarkers: A meta-analysis of randomized controlled trials

Leonardo Buttice et al. Diabetes Obes Metab. 2024 Jul.

Abstract

Aims: To conduct a meta-analysis of randomized controlled trials (RCTs) to assess the effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors on inflammatory biomarkers.

Methods: Medline, Embase and the Cochrane Library were searched for RCTs investigating the effect of SGLT2 inhibitors on inflammatory biomarkers, adipokine profiles and insulin sensitivity.

Results: Thirty-eight RCTs were included (14 967 participants, 63.3% male, mean age 62 ± 8.6 years) with a median (interquartile range) follow-up of 16 (12-24) weeks. Meta-analysis showed that SGLT2 inhibitors significantly improved adiponectin, interleukin-6, tumour necrosis factor receptor-1 (vs. placebo alone: standardized mean difference [SMD] 0.34 [95% confidence interval {CI} 0.23, 0.45], mean difference [MD] -0.85 pg/mL [95% CI -1.32, -0.38], SMD -0.13 [95% CI -0.20, -0.06], respectively), leptin and homeostatic model assessment of insulin resistance index (vs.

Control: SMD -0.20 [95% CI -0.33, -0.07], MD -0.83 [95% CI -1.32, -0.33], respectively). There were no significant changes in C-reactive protein (CRP), tumour necrosis factor-α, plasminogen activator inhibitor-1, fibroblast growth factor-21 or monocyte chemoattractant protein-1.

Conclusions: Our analysis shows that SGLT2 inhibitors likely improve adipokine biomarkers and insulin sensitivity, but there is little evidence that SGLT2 inhibitors improve other inflammatory biomarkers including CRP.

Keywords: cardiovascular disease; dapagliflozin; empagliflozin; inflammation; mechanism of action; sodium‐glucose co‐transporter‐2 inhibitors.

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References

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