Sodium-Glucose Cotransporter 2 Inhibitor Use and Risk of Liver-Related Events in Patients With Type 2 Diabetes: A Meta-analysis of Observational Cohort Studies.

We performed a meta-analysisof observational cohort studies to quantify the magnitude of the association between SGLT2 inhibitor use and risk of developing MALOs for people with type 2 diabetes mellitus (T2DM).

我们对观察性队列研究进行了荟萃分析，以量化SGLT2抑制剂使用与2型糖尿病患者发展为MALOs风险之间的关联程度。

data_sources

We systematically reviewed three large electronic databases from inception to January 2025.

我们系统地审查了从创刊至2025年1月的三个大型电子数据库。

study_selection

We included active-comparator, new-user cohort studies with comparison of SGLT2 inhibitors versus other glucose-lowering medications in patients with T2DM.

我们纳入了活性对照、新用户队列研究，比较了SGLT2抑制剂与其他降糖药物在2型糖尿病患者中的效果。

data_extraction

The primary outcome was incidencerate of MALOs defined as a composite of hepatic decompensation events, hepatocellular carcinoma, liver transplantation, or liver-related deaths.

主要结果是MALOs的发生率，定义为肝功能失代偿事件、肝细胞癌、肝移植或与肝相关的死亡的复合事件。

Secondary outcomes included each of the above as individual events.

次要结果包括上述每一项作为单独事件。

Meta-analysiswas performed with random-effects models.

采用随机效应模型进行了荟萃分析。

data_synthesis

We identified eight cohort studies with aggregate data on 626,104 patients with T2DM (397,806 SGLT2 inhibitor new users and 228,298 new users of other glucose-lowering agents).

我们确定了八项队列研究，这些研究汇总了626,104名2型糖尿病患者的资料（397,806名SGLT2抑制剂新用户和228,298名其他降糖药物新用户）。

During a median of 2.7 years, SGLT2 inhibitor use was associated with significantly lower risk of MALOs (random-effects hazard ratio0.83, 95% CI 0.72-0.95; I2 = 83.1%) and liver-related deaths (0.64, 0.50-0.82; I2 = 0%).

在中位随访2.7年期间，钠-葡萄糖共转运蛋白2（SGLT2）抑制剂的使用与显著降低主要不良肝事件（MALOs）的风险相关（随机效应风险比为0.83，95%置信区间为0.72-0.95；I2=83.1%）以及与肝相关死亡风险的降低（0.64，95%置信区间为0.50-0.82；I2=0%）。

The significant risk reduction in MALOs was observed in comparisons of SGLT2 inhibitors with dipeptidyl peptidase 4 inhibitors, metformin, or pioglitazone but not glucagon-like peptide 1 receptor agonists.

与二肽基肽酶4（DPP-4）抑制剂、二甲双胍或吡格列酮相比，SGLT2抑制剂显著降低了MALOs的风险，但在与胰高血糖素样肽1（GLP-1）受体激动剂的比较中并未观察到这种风险降低。

Sensitivity analyses did not modify these results.

敏感性分析并未改变这些结果。

A funnel plot did not show significant publication bias.

漏斗图并未显示出显著的发表偏倚。

limitations

Observational design of the cohort studies and high level of heterogeneity are the main limitations.

观察性队列研究的设计和高水平的异质性是主要局限性。

Conclusions

SGLT2 inhibitor use was associated with lower risk of MALOs for patients with T2DM.

SGLT2抑制剂的使用与2型糖尿病患者发生主要不良下肢事件（MALOs）的较低风险相关。