Hormonal
GLP-1 receptor agonists (exenatide, liraglutide, dulaglutide, semaglutide, tirzepatide) reduce hepatic lipid accumulation in MASLD patients, primarily through indirect mechanisms involving weight loss and reduced fatty acid deposition, and directly by improving insulin sensitivity and suppressing de novo lipogenesis.
GLP-1 agonists like semaglutide and tirzepatide are effective treatments for reducing liver fat in people with MASLD, especially if they also have type 2 diabetes or obesity. They work by improving insulin sensitivity and directly reducing fat production in the liver, in addition to helping with weight loss. While they significantly reduce liver fat, they may not reverse advanced scarring (fibrosis). Consistency is key, as side effects and cost can lead to stopping treatment.
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.
Why this rating
The paper is a narrative review citing multiple clinical trials and MRI-PDFF studies, but lacks a single large-scale primary RCT with histological endpoints.
Source
O EFEITO DOS ANÁLOGOS DE GLP1 NA MASLD: MECANISMOS, EVIDÊNCIAS E PERSPECTIVAS
Leonardo Lucas Prudente et al. · Revista Multidisciplinar do Nordeste Mineiro · 2025
DOI 10.61164/t9z40s73
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