Abstract
The influence of sodium-glucose cotransporter-2 (SGLT-2) inhibitors on plasma
adiponectin remains not comprehensively evaluated. We performed a meta-analysis
to systematically evaluate the effect of SGLT2 inhibitors on plasma level of
adiponectin in patients with type 2 diabetes mellitus (T2DM). Randomized
controlled trials comparing SGLT-2 inhibitors with non-active controls on plasma
adiponectin in T2DM patients were retrieved by search of the Medline (PubMed),
Embase, and CENTER (Cochrane Library) databases from inception to April 5, 2022.
Study characteristics and outcome data were independently extracted by two
authors. A random-effect model by incorporating the potential between-study
heterogeneity was used to combine the results. Fourteen studies with 2142
patients contributed to the meta-analysis. Compared to placebo, SGLT-2
inhibitors significantly increased plasma adiponectin [standard mean difference
(SMD): 0.35, 95% CI: 0.24 to 0.46, p<0.001] with mild
heterogeneity (I2=19%). Predefined subgroup analyses suggested
that tofogliflozin (SMD: 0.37, p<0.001), luseogliflozin (SMD: 0.51,
p<0.001), and ipragliflozin (SMD: 0.34, p<0.001) were associated
with increased adiponectin, but not for dapagliflozin (SMD: 0.14, p 0.26). In
addition, SGLT-2 inhibitors were associated with increased adiponectin in
studies from Asia (SMD: 0.42, p<0.001), but not in studies from the
western countries (SMD: 0.16, p 0.17). Moreover, the increment of adiponectin
was more significant in patients with body mass index
(BMI)<30 kg/m2 (SMD: 0.46, p<0.001) than that in
patients with BMI≤30 kg/m2 (SMD: 0.19, p 0.02, p for
subgroup difference 0.01). In conclusion, SGLT-2 inhibitors could significantly
increase plasma adiponectin as compared with placebo in T2DM patients.
Key words sodium-glucose cotransporter-2 inhibitors - adiponectin, metabolic syndrome - type 2 diabetes mellitus - meta-analysis
