The Impact of Liraglutide on Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease

Abstract

Background/Aims: Liraglutide, a glucagon-like-peptide-1 (GLP-1) receptor agonist, improves hepatic steatosis and metabolic parameters. We evaluated the impact of liraglutide on liver stiffness (LS) and steatosis by vibration-controlled transient elastography (VCTE) and metabolic parameters in patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Methods: This retrospective cohort study included 197 patients with MASLD who received liraglutide between 2020 and 2023. VCTE assessed changes in LS values and controlled attenuation parameter (CAP). Metabolic parameters, including body mass index (BMI), glycemic markers, and lipid profiles, were evaluated at baseline, 2 months, and 6 months after liraglutide treatment. Results: The median follow-up duration was 5.9 months. Of 197 patients, 172 had follow-up data at 2 months and 142 at 6 months. At baseline, mean LS and CAP were 7.5 kPa and 327 dB/m. CAP significantly decreased at 2 months (mean Delta - 26.0 dB/m, p < 0.001), but not at 6 months (mean Delta - 20.6 dB/m, p = 0.384). LS showed no significant change at either time point (mean 7.0 kPa at 2 months and 7.2 kPa at 6 months; all p > 0.05). BMI (from 30.9 to 28.9 kg/m(2), p < 0.001), HbA1c (from 6.3% to 6.2%, p = 0.352), and homeostatic model assessment of insulin resistance (HOMA-IR) improved significantly over 6 months, and the proportion of patients meeting MASLD criteria declined. Conclusions: Liraglutide improved hepatic steatosis and metabolic parameters, not LS, in patients with MASLD, though its effect on LS was limited. These findings support the favorable influence of liraglutide on MASLD management.