Subgroup analysis based on whether or not NAFLD was merged with T2DM showed that SGLT-2 inhibitors significantly reduced liver fat only in patients with NAFLD in T2DM (SMD = − 0.82; 95% CI [− 1.43, − 0.21]; I2 = 77%; p = 0.008) compared with that in patients without NAFLD in T2DM (SMD = − 0.25; 95% CI [− 0.80, 0.30]; p = 0.37; Additional file 1: Fig. S1D and Table S1). Here, SLC5A2 is linked to metabolic dysfunction-associated steatotic liver disease.