Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Nov 26, 2022; 14(11): 599-616
Published online Nov 26, 2022. doi: 10.4330/wjc.v14.i11.599
Potential for sodium-glucose cotransporter-2 inhibitors in the management of metabolic syndrome: A systematic review and meta-analysis
Abdulbaril Olagunju, Naser Yamani, Dorothy Kenny, Martina Mookadam, Farouk Mookadam, Samuel Unzek
Abdulbaril Olagunju, Dorothy Kenny, Internal Medicine, Creighton University School of Medicine, Phoenix, AZ 85013, United States
Naser Yamani, Farouk Mookadam, Samuel Unzek, Cardiology, Heart Center, University of Arizona College of Medicine-Phoenix, Banner University Medical Center, Phoenix, AZ 85006, United States
Martina Mookadam, Department of Family Medicine, Mayo Clinic, Scottsdale, AZ 85260, United States
Author contributions: Olagunju A, Mookadam M and Mookadam F designed the research; Olagunju A, Kenny D, Yamani N performed the research; Olagunju A, Kenny D, Yamani N, Mookadam M, Mookadam F and Unzek S analysed the data; Olagunju A, Kenny D, Yamani N and Mookadam F wrote the paper.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abdulbaril Olagunju, MD, Doctor, Internal Medicine, Creighton University School of Medicine, 350 W Thomas Road, Phoenix, AZ 85013, United States. ab.dapoola@gmail.com
Received: July 3, 2022
Peer-review started: July 3, 2022
First decision: August 22, 2022
Revised: September 17, 2022
Accepted: October 27, 2022
Article in press: October 27, 2022
Published online: November 26, 2022
Processing time: 144 Days and 1.4 Hours
Abstract
BACKGROUND

Landmark trials have established the benefits of sodium-glucose cotransporter-2 inhibitors (SGLT2-Is) in cardiovascular disease including heart failure with reduced and preserved ejection fraction and renal diseases regardless of the presence of diabetes mellitus. However, studies evaluating the role of SGLT2-Is in metabolic syndrome (MetS) are limited.

AIM

This study primarily aimed to evaluate the impact of SGLT2-Is on the components of MetS.

METHODS

Two independent reviewers and an experienced librarian searched Medline, Scopus and the Cochrane central from inception to December 9, 2021 to identify placebo controlled randomized controlled trials that evaluated the impact of SGLT2-Is on the components of MetS as an endpoint. Pre- and post-treatment data of each component were obtained. A meta-analysis was performed using the RevMan (version 5.3; Copenhagen: The Nordic Cochrane Center, The Cochrane Collaboration).

RESULTS

Treatment with SGLT2-Is resulted in a decrease in fasting plasma glucose (–18.07 mg/dL; 95%CI: -25.32 to –10.82), systolic blood pressure (–1.37 mmHg; 95%CI: -2.08 to –0.65), and waist circumference (–1.28 cm; 95%CI: -1.39 to –1.18) compared to placebo. The impact on high-density lipoprotein cholesterol was similar to placebo (0.01 mg/dL; 95%CI: -0.05 to 0.07).

CONCLUSION

SGLT2-Is have a promising role in the management of MetS.

Keywords: Metabolic syndrome; Sodium-glucose cotransporter 2 inhibitors; Dapagliflozin; Empagliflozin; Cardiovascular disease

Core Tip: This meta-analysis of randomized, placebo-controlled trials aimed to evaluate the impact of dapagliglozin and empagliflozin on metabolic syndrome as defined by the National Cholesterol Education Program Adult Treatment Panel III. In doing so, it highlighted a statistically significant improvement in fasting plasma glucose, systolic blood pressure and waist circumference. The effect of dapagliflozin and empagliflozin on high-density lipoprotein cholesterol was similar to that of placebo. In addition to its primary aim, this study also highlighted an improvement in other cardiometabolic parameters including hemoglobin A1C, uric acid and body weight in patients that received dapagliflozin and empagliflozin.