THE EFFECT OF GLP-1 ANALOGUES ON MASLD: MECHANISMS, EVIDENCE AND PERSPECTIVES
DOI:
https://doi.org/10.61164/t9z40s73Keywords:
liver; , therapeutics; , weight reduction.Abstract
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is strongly associated with obesity and type 2 diabetes mellitus, which are considered current global epidemics. This work aimed to provide a comprehensive overview of the role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in MASLD. The literature analysis, conducted using the PubMed/Medline database, demonstrates that the main representatives of this drug class are: exenatide, liraglutide, dulaglutide, semaglutide, and tirzepatide. These medications exert hepatoprotective effects through indirect mechanisms via weight loss and reduced fatty acid deposition in the liver, and directly by improving insulin sensitivity, reducing excessive activation of de novo lipogenesis, and modulating inflammatory cytokines. Magnetic resonance imaging (MRI-PDFF) is a useful non-invasive approach for quantifying hepatic fat accumulation, and this method has demonstrated reductions in hepatic lipids in patients treated with GLP-1 RAs. Despite this promising profile, the treatment faces limitations, including variable response, modest effects on advanced fibrosis, and high cost, which influence treatment persistence. Future perspectives focus on the development of multi-agonists (e.g., GLP-1/GIP) and the development of long-term studies. GLP-1 RAs are considered major therapeutic advances and, regarding MASLD, show promising effects for efficiently treating and preventing the progression of this disease.
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