ReviewDiabetology & metabolic syndrome2026
Glucagon-like peptide-1 receptor agonists improve hepatic histology and metabolic parameters in type 2 diabetes with MASLD: a meta-analysis of randomized controlled trials.
Review in Diabetology & metabolic syndrome, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent condition with limited pharmacological options. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as potential therapies for MASLD, but their efficacy and safety have not been comprehensively evaluated. This meta-analysis aimed to assess the effects of GLP-1 RA therapy on liver function, glycemic control, lipid profile, and obesity indices in adults with type 2 diabetes and MASLD.
methodsA systematic search of PubMed, Scopus, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Database was conducted to identify randomized controlled trials (RCTs) evaluating GLP-1 RA therapy in MASLD, published up to January 2025.
resultsEleven RCTs involving 1,047 participants (GLP-1 RA, n = 582; control, n = 465) were included. GLP-1 RA therapy significantly reduced liver fat content (SMD: -0.98; 95% CI: -1.51 to -0.46) and increased the odds of liver histology resolution (OR: 3.69; 95% CI: 2.30 to 5.93). Liver enzymes were significantly improved: ALT (SMD: -0.54; 95% CI: -0.78 to -0.30), AST (SMD: -0.45; 95% CI: -0.71 to -0.19), and γ-GGT (SMD: -0.51; 95% CI: -0.77 to -0.24). GLP-1 RAs modest but significant lowered HbA1c (SMD: -0.34; 95% CI: -0.57 to -0.12) and reduced weight (SMD: -0.93; 95% CI: -1.27 to -0.59) and BMI (SMD: -0.92; 95% CI: -1.28 to -0.56), but had no significant effects on fasting glucose, HOMA-IR, or lipid profile. GLP-1 RAs were associated with a lower risk of hypoglycemia (OR: 0.37; 95% CI: 0.14 to 0.95).
conclusionGLP-1 RA therapy appears effective in improving liver fat, liver enzymes, HbA1c, and obesity indices in MASLD, with a favorable hypoglycemia profile, though gastrointestinal adverse events are more common. Larger long-term trials are needed to confirm these effects.
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