The effects of glucagon-like peptide-1 receptor agonists on glycemic control and anthropometric profiles among diabetic patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis of randomized controlled trials

Abstract

This study was undertaken to assess the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs), mainly liraglutide and exenatide, on glycemic control and anthropometric profiles to see if they are effective in treating patients with non-alcoholic fatty liver disease (NAFLD) and type-2 diabetes mellitus (T2DM). We searched PubMed, Embase, Scopus, Web of Science (WOS), and Cochrane Library databases to identify all the randomized clinical trials (RCTs) up to August 23, 2020. Heterogeneity of the included studies was evaluated using Cochrane's Q test and the I2 statistic. Moreover, a random-effects model was used to pool the weighted mean differences (WMDs) and their 95% confidence intervals (CIs). Nine articles (12 studies) comprising a total of 780 participants aged 40–56 were finally selected. GLP-1RAs intake significantly reduced body mass index (BMI) (WMD -1.57, 95%CI; −2.74, −0.39), waist-circumference (WC) (WMD -4.14, 95%CI; −7.09, −1.19), body weight (WMD -4.20, 95%CI; −8.15, −0.25) among the body mass indices. Additionally, GLP-1RAs leads to lower postprandial plasma glucose (PPG) levels (WMD -25.73 mg/dl, 95%CI; −32.71, −18.75). We also found that GLP-1RAs intake has no significant effect on the waist-hip ratio (WHR) (WMD -0.01, 95%CI; −0.03, 0.02), fasting blood glucose (FBG) (WMD -2.12 mg/dl, 95%CI; −6.23, 1.96), hemoglobin A1c (HbA1c) (WMD -0.08%, 95%CI; −0.21, 0.04), and homeostatic model assessment for insulin resistance (HOMA-IR) levels (WMD -0.31, 95%CI; −0.69, 0.07). GLP-1RAs therapy showed a greater reduction in BMI, body weight, WC, and PPG, but not in WHR, HOMA-IR, FBG, and HbA1c compared with other therapies in patients with T2DM and NAFLD.