Bołdys Aleksandra, Bułdak Łukasz, Nicze Michał, Okopień Bogusław
Department of Internal Medicine and Clinical Pharmacology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland.
Int J Mol Sci. 2025 Jun 19;26(12):5883. doi: 10.3390/ijms26125883.
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a leading cause of liver cirrhosis, with its global prevalence rising due to obesity, insulin resistance, and type 2 diabetes mellitus. While bariatric surgery remains effective for weight loss, Glucagon-Like Peptide-1 analogs such as liraglutide are emerging as promising pharmacological treatments. This study aimed to evaluate the effects of a 3-month liraglutide treatment on liver steatosis, subclinical markers, and insulin resistance in non-diabetic, obese patients with MASLD. Twenty-eight obese adults (BMI ≥ 30 kg/m) were treated with daily subcutaneous liraglutide injections for three months. Liver steatosis was assessed using FibroScan (CAP score) and non-invasive indices (Hepatic Steatosis Index-HSI, and NAFLD Liver Fat Score-NLFS). Insulin resistance was measured with conventional markers (HOMA-IR, QUICKI) and triglyceride-based indices (METS-IR, TyG). Liraglutide significantly reduced liver steatosis (CAP score: 305 to 268 dB/m, < 0.05) and improved HSI, while NLFS remained unchanged. Despite significant weight loss, traditional insulin resistance markers remained unchanged, while METS-IR and TyG improved. Liraglutide therapy improved liver steatosis and triglyceride-based insulin resistance markers in non-diabetic obese patients with MASLD. These findings support the use of liraglutide, highlighting the value of personalized approaches and alternative insulin resistance assessments in MASLD management.
代谢功能障碍相关脂肪性肝病(MASLD)是肝硬化的主要病因,由于肥胖、胰岛素抵抗和2型糖尿病,其全球患病率正在上升。虽然减肥手术对体重减轻仍然有效,但胰高血糖素样肽-1类似物(如利拉鲁肽)正在成为有前景的药物治疗方法。本研究旨在评估3个月利拉鲁肽治疗对非糖尿病肥胖MASLD患者肝脂肪变性、亚临床指标和胰岛素抵抗的影响。28名肥胖成年人(BMI≥30kg/m)接受每日皮下注射利拉鲁肽治疗3个月。使用FibroScan(CAP评分)和非侵入性指标(肝脂肪变性指数-HSI和非酒精性脂肪性肝病肝脂肪评分-NLFS)评估肝脂肪变性。用传统指标(HOMA-IR、QUICKI)和基于甘油三酯的指标(METS-IR、TyG)测量胰岛素抵抗。利拉鲁肽显著降低了肝脂肪变性(CAP评分:从305降至268dB/m,<0.05)并改善了HSI,而NLFS保持不变。尽管体重显著减轻,但传统胰岛素抵抗指标保持不变,而METS-IR和TyG有所改善。利拉鲁肽治疗改善了非糖尿病肥胖MASLD患者的肝脂肪变性和基于甘油三酯的胰岛素抵抗指标。这些发现支持使用利拉鲁肽,突出了个性化方法和替代胰岛素抵抗评估在MASLD管理中的价值。