The effect of glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide receptor agonists in nonalcoholic fatty liver disease in type 2 diabetic patients: a systematic review and meta-analysis

Abstract

Background: Non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are prevalent conditions often coexisting and significantly impacting patient health. Glucagon-like peptide-1 (GLP-1) receptor agonists, such as liraglutide, dulaglutide, semaglutide, efinopegdutide, and cotadutide, have shown promise in managing these conditions. This study aims to evaluate the efficacy of these medications on metabolic and liver-related outcomes in patients with T2DM and NAFLD. Methodology: A comprehensive analysis of multiple randomized controlled trials (RCTs) was conducted to assess the impact of GLP-1 receptor agonists on body mass index (BMI), glycemic control (HbA1c), blood pressure, lipid profiles, and liver enzymes. The patient populations, interventions, and control groups were compared across these studies to derive comprehensive insights. Results: GLP-1 receptor agonists significantly improved metabolic and liver-related outcomes. Patients on liraglutide, dulaglutide, and semaglutide showed marked reductions in BMI and HbA1c levels, indicating effective weight management and glycemic control. Improvements in lipid profiles were observed, with notable reductions in triglycerides and increases in HDL levels. Significant reductions in liver enzymes (ALT and AST) were reported, particularly with efinopegdutide and cotadutide, indicating improved liver health. Gastrointestinal side effects, such as nausea and vomiting, were common but generally mild and transient. Conclusion: The study demonstrates that GLP-1 receptor agonists are effective in managing both metabolic and liver-related outcomes in patients with T2DM and NAFLD. These medications significantly reduce BMI, improve glycemic control and lipid profiles, and lower liver enzyme levels, indicating enhanced liver health. While mild gastrointestinal side effects were reported, the overall safety and efficacy profiles of these drugs make them promise therapeutic options. Future research should focus on long-term effects and optimal dosing strategies to maximize therapeutic benefits and minimize side effects.