Subgroup analysis based on whether or not NAFLD was merged with T2DM showed that the SGLT-2 inhibitor significantly reduced VAT in patients with NAFLD in T2DM (SMD = − 2.73; 95% CI [− 4.33, − 1.13]; I2 = 97%; p = 0.0008) compared with that in patients without NAFLD in T2DM (SMD = − 0.60; 95% CI [− 0.94, − 0.27]; I2 = 70%; p = 0.0004; Fig. 4D). Here, SLC5A2 is linked to metabolic dysfunction-associated steatotic liver disease.