Sodium glucose cotransporter 2 (SGLT2) inhibitors provide cardiometabolic benefits in adults with type 2 diabetes mellitus, yet their effects on lipid metabolism are reported inconsistently across clinical trials and mechanistic studies and may vary with background statin therapy and differences in lipid measurement and reporting. We conducted a systematic review to evaluate the impact of SGLT2 inhibitors on conventional lipid parameters first and selected advanced lipid markers second in adults with type 2 diabetes. We searched multiple databases using predefined eligibility criteria and extracted data in duplicate. We assessed the risk of bias using design-appropriate tools and synthesized findings qualitatively because heterogeneity limited quantitative pooling. Overall, evidence across included studies suggests that SGLT2 inhibitors are essentially neutral with respect to low-density lipoprotein cholesterol (LDL-C), with generally favorable directions for high-density lipoprotein cholesterol (HDL-C) and triglycerides in some study settings. At the same time, findings on qualitative lipoprotein remodeling and advanced lipid phenotypes remain heterogeneous. These results support a lipid neutral to mildly favorable profile on standard lipid panels and emphasize the need for standardized reporting of advanced lipid measures and longer follow-up to clarify clinical relevance.
Abdalla et al. (Fri,) studied this question.