Glucagon-Like Peptide-1 Receptor Agonists for Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes: A Meta-Analysis - PubMed (original) (raw)

Meta-Analysis

Glucagon-Like Peptide-1 Receptor Agonists for Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes: A Meta-Analysis

Chloe Wong et al. Front Endocrinol (Lausanne). 2021.

Abstract

Objective: Non-alcoholic fatty liver disease is highly prevalent in patients with type 2 diabetes mellitus. Studies on glucagon-like peptide-1 receptor agonists for the treatment of non-alcoholic fatty liver disease have reported promising results. Despite this, there has been limited evidence of its efficacy in non-alcoholic fatty liver disease patients with type 2 diabetes mellitus. This meta-analysis examined existing evidence on the efficacy of glucagon-like peptide-1 receptor agonists on the management of non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus.

Methods: Medline, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for articles discussing the efficacy of glucagon-like peptide-1 receptor agonists on non-alcoholic fatty liver disease in patients with type 2 diabetes mellitus. Values of standardized mean differences (SMD) and risk ratio (RR) were determined for continuous outcomes and dichotomous outcomes respectively.

Results: 8 studies involving 1,454 patients from 5 randomized controlled trials and 3 cohort studies were included in the analysis. Our analysis found significant improvements in hepatic fat content, liver biochemistry, body composition, glucose parameters, lipid parameters, insulin sensitivity and inflammatory markers following glucagon-like peptide-1 receptor agonist treatment. Glucagon-like peptide-1 receptor agonists significantly decreased hepatic fat content compared to metformin and insulin-based therapies. Glucagon-like peptide-1 receptor agonists also improved fibrosis markers, but this did not reach statistical significance.

Conclusion: With a high prevalence of obesity and non-alcoholic fatty liver disease among patients with type 2 diabetes mellitus, glucagon-like peptide-1 receptor agonist treatment shows promise in improving both diabetes and non-alcoholic fatty liver disease phenotype.

Keywords: GLP-1RA; glucagon-like peptide-1 receptor agonist; meta-analysis; non-alcoholic fatty liver disease; type 2 diabetes mellitus.

Copyright © 2021 Wong, Lee, Yaow, Chin, Goh, Ng, Lim, Muthiah and Khoo.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1

Figure 1

PRISMA flow diagram.

Figure 2

Figure 2

Risk of bias assessment.

Figure 3

Figure 3

Hepatic fat content after GLP-1RA treatment.

Figure 4

Figure 4

Hepatic fat content comparisons between GLP-1RA and controls.

Figure 5

Figure 5

BMI after GLP-1RA treatment.

Figure 6

Figure 6

Triglycerides after GLP-1RA treatment.

References

    1. Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology (2016) 64(1):73–84. 10.1002/hep.28431 - DOI - PubMed
    1. Carr RM, Oranu A, Khungar V. Nonalcoholic Fatty Liver Disease: Pathophysiology and Management. Gastroenterol Clin North Am (2016) 45(4):639–52. 10.1016/j.gtc.2016.07.003 - DOI - PMC - PubMed
    1. Cobbina E, Akhlaghi F. Non-alcoholic fatty liver disease (NAFLD) - pathogenesis, classification, and effect on drug metabolizing enzymes and transporters. Drug Metab Rev (2017) 49(2):197–211. 10.1080/03602532.2017.1293683 - DOI - PMC - PubMed
    1. Dai W, Ye L, Liu A, Wen SW, Deng J, Wu X, et al. Prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus: A meta-analysis. Med (Baltimore) (2017) 96(39):e8179. 10.1097/md.0000000000008179 - DOI - PMC - PubMed
    1. Lonardo A, Nascimbeni F, Mantovani A, Targher G. Hypertension, diabetes, atherosclerosis and NASH: Cause or consequence? J Hepatol (2018) 68(2):335–52. 10.1016/j.jhep.2017.09.021 - DOI - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources