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利拉鲁肽可减轻非糖尿病肥胖患者的肝脏脂肪变性并改善代谢指标:一项为期3个月的前瞻性研究。

Liraglutide Reduces Liver Steatosis and Improves Metabolic Indices in Obese Patients Without Diabetes: A 3-Month Prospective Study.

作者信息

Bołdys Aleksandra, Bułdak Łukasz, Nicze Michał, Okopień Bogusław

机构信息

Department of Internal Medicine and Clinical Pharmacology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland.

出版信息

Int J Mol Sci. 2025 Jun 19;26(12):5883. doi: 10.3390/ijms26125883.

Abstract

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.

摘要

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。

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