SGLT2 inhibitors are associated with reductions in epicardial adipose tissue volume and thickness: a meta-analysis
Pooled result · EATResult — go to the resultHedges g - 1.64 95% CI −2.10 to −1.18Authors' conclusion
SGLT2i significantly reduces EAT volume and thickness, which may contribute to their broad cardiovascular benefits.
Study context
- Population
- Patients with serial epicardial adipose tissue (EAT) measurement by CT, echocardiography or cardiac MRI before and after SGLT2i treatment, or SGLT2i vs conventional therapy
- Participants
- 284 patients11 studies
- Comparison
- SGLT2i vs conventional antidiabetic therapy; pre- vs post-SGLT2i
- Outcome
- Change in epicardial adipose tissue (EAT)
Methodological detailsrandom-effects models, standardised mean differences
- Random-effects models
- Standardised mean differences
Pooled result
EAT
Hedges g
- 1.64
95% CI −2.10 to −1.18
P < 0.01
SGLT2ivs Conventional therapy
Hedges g - 1.64 (95% CI −2.10 to −1.18); P < 0.01
As reported in the abstract
Further pooled results
EAT, baseline to follow-up with SGLT2i (exploratory within-group)
- Hedges g (95% CI −0.88 to −0.36; p < 0.01)
- - 0.62
- Exploratory
EAT thickness (echocardiography), subgroup
- Hedges g (95% CI −1.05 to −0.43; p < 0.01)
- - 0.74
- p = 0.32 for interaction between modalities
EAT volume (CT/CMR), subgroup
- Hedges g (95% CI −0.90 to −0.18; p < 0.01)
- - 0.54
- p = 0.32 for interaction between modalities
BMI
- Hedges g (95% CI −0.43 to −0.03; p = 0.03)
- - 0.23
Systolic blood pressure
- Hedges g (95% CI −0.59 to −0.05; p = 0.02)
- - 0.32
EAT reduction by agent (exploratory subgroup)
- Larger EAT reductions with dapagliflozin vs empagliflozin; indirect, small number of heterogeneous studies, hypothesis-generating only
- Exploratory
Original publication
SGLT2 inhibitors are associated with reductions in epicardial adipose tissue volume and thickness: a meta-analysis. Int J Obes (Lond). Published 27 May 2026. doi:10.
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