Effect of sodium-glucose co-transporter 2 inhibitors on lipid profile: a systematic review and meta-analysis of 48 randomized controlled trials.

Previous studies have suggested additional beneficial effects of sodium-glucose co-transporter-2 (SGLT2) inhibitors including the lipid-lowering effect; however, results on lipid profile are controversial. Thus, this meta-analysis aimed to determine the effect of SGLT2 inhibitors treatment on lipid levels in patients with type 2 diabetes. Randomized controlled trials assessing the impact of SGLT2 inhibitors on lipid parameters were searched in PubMed-MEDLINE, SCOPUS, Web of Science, and Google Scholar databases. Meta-analysis was conducted using a random-effects model and generic inverse variance method. Meta-analysis of 48 randomized controlled trials revealed that SGLT2 inhibitors therapy had a significant increase on total cholesterol (WMD: 0.09 mmol/L, 95% CI: 0.05, 0.13, I2 = 79%, p < 0.0001), LDL-cholesterol (WMD: 0.10 mmol/L, 95% CI: 0.07, 0.12, I2 = 94%, p < 0.00001), HDL-cholesterol (WMD: 0.06 mmol/L, 95% CI: 0.05, 0.08, I2 = 99%, p < 0.00001), and non-HDL-cholesterol (WMD: 0.09 mmol/L, 95% CI: 0.06, 0.12, I2 = 96%, p < 0.00001). Additionally, SGLT2 inhibitors administration showed a significant decrease in triglyceride levels (WMD: -0.10 mmol/L, 95% CI: -0.13, -0.07, I2 = 96%, p < 0.00001). Finally, no significant alteration was found on LDL/HDL ratio after SGLT2 inhibitors treatment (WMD: -0.01 mmol/L, 95% CI: -0.05, 0.03, I2 = 99%, p =  0.65). In conclusion, SGLT2 inhibitors significantly increase total cholesterol, LDL-cholesterol, non-HDL-cholesterol, and HDL-cholesterol, and decrease triglyceride levels.