Effects of GLP-1 receptor agonists on the degree of liver fibrosis and CRP in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: A systematic review and meta-analysis

Prim Care Diabetes. 2024 Jun;18(3):268-276. doi: 10.1016/j.pcd.2024.03.005. Epub 2024 Mar 30.

Abstract

Background: Based on the rapidly growing global burden of non-alcoholic fatty liver disease (NAFLD) or steatohepatitis (NASH), in order to evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in the treatment of NAFLD or NASH this paper presents a systematic review and meta-analysis of randomized controlled trials(RCTs).

Methods: In this systematic review and meta-analysis, We searched PubMed, Medline, Web of Science and The Cochrane Library databases. All randomized controlled trials involving GLP-1RAs and NAFLD or NASH were collected since the database was established. A meta-analysis of proportions was done with the generalised linear mixed model. Continuous variables were represented by Mean and Standard Deviation (SD), and binary variable were represented by Relative Risk (RR) and 95% Confidence Interval (CI) as effect indicators. The research results were presented by Revman 5.4. This study is registered with PROSPERO (CRD42023390735).

Finding: We included 16 placebo-controlled or active drug-controlled randomized controlled trials (involving 2178 patients) that used liraglutide, exenatide, dulaglutide, or semaglutie in the treatment of NAFLD or NASH, as measured by liver biopsy or imaging techniques. This study found that the effect of GLP-1RAs on histologic resolution of NASH with no worsening of liver fibrosis (n=2 RCTs; WMD:4.08, 95%CI 2.54-6.56, p < 0.00001) has statistically significant. At the same time, GLP-1RAs affected CRP (n = 7 RCTs; WMD:-0.41, 95% CI-0.78 to -0.04, p =0.002) and other serological indicators were significantly improved.

Conclusion: This study evaluated the efficacy of GLP-1RAs in patients with NAFLD and NASH. These results suggest that GLP-1RAs may be a potential and viable therapeutic approach as a targeted agent to intervene in disease progression of NAFLD and NASH.

Keywords: Glucagon-like peptide-1 receptor agonists; Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Adult
  • Aged
  • Biomarkers* / blood
  • C-Reactive Protein* / analysis
  • C-Reactive Protein* / metabolism
  • Female
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Glucagon-Like Peptides / adverse effects
  • Glucagon-Like Peptides / analogs & derivatives
  • Glucagon-Like Peptides / therapeutic use
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Immunoglobulin Fc Fragments / therapeutic use
  • Incretins* / adverse effects
  • Incretins* / therapeutic use
  • Liraglutide / therapeutic use
  • Liver / drug effects
  • Liver / pathology
  • Liver Cirrhosis* / diagnosis
  • Liver Cirrhosis* / drug therapy
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease* / blood
  • Non-alcoholic Fatty Liver Disease* / drug therapy
  • Randomized Controlled Trials as Topic*
  • Recombinant Fusion Proteins / therapeutic use
  • Risk Factors
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Biomarkers
  • GLP1R protein, human
  • Incretins
  • C-Reactive Protein
  • Hypoglycemic Agents
  • Recombinant Fusion Proteins
  • Immunoglobulin Fc Fragments
  • Liraglutide
  • Glucagon-Like Peptides
  • Glucagon-Like Peptide-1 Receptor Agonists