Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas.
Gastroenterology and Hepatology, Creighton University, Phoenix, Arizona.
Clin Gastroenterol Hepatol. 2024 Aug;22(8):1565-1574. doi: 10.1016/j.cgh.2024.01.032. Epub 2024 Feb 15.
Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 1 in 3-4 adult individuals and can progress to metabolic dysfunction-associated steatohepatitis (MASH) and cirrhosis. Insulin resistance plays a central role in MASLD/MASH pathophysiology with higher rates of MASLD (2 in 3) and MASH with fibrosis (1 in 5) in adults with obesity and diabetes. This review summarizes the role of glucagon-like peptide-1 receptor agonists in treating MASLD/MASH. Although not approved by the Food and Drug Administration for the treatment of MASLD, this class of medication is available to treat obesity and type 2 diabetes and has been shown to reverse steatohepatitis, reduce cardiovascular risk, and is safe to use across the spectrum of MASLD with or without fibrosis.
代谢功能障碍相关脂肪性肝病(MASLD)影响每 3-4 位成年人中的 1 位,并且可能进展为代谢功能障碍相关脂肪性肝炎(MASH)和肝硬化。胰岛素抵抗在 MASLD/MASH 病理生理学中起着核心作用,肥胖和糖尿病患者中 MASLD(2/3)和纤维化性 MASH(1/5)的发生率更高。本综述总结了胰高血糖素样肽-1 受体激动剂在治疗 MASLD/MASH 中的作用。尽管这些药物尚未被美国食品和药物管理局批准用于治疗 MASLD,但该类药物可用于治疗肥胖症和 2 型糖尿病,并且已被证明可逆转脂肪性肝炎,降低心血管风险,并且在有或没有纤维化的 MASLD 谱中使用都是安全的。