Abstract
Introduction: Treatment options for nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes (T2D), two conditions which coexist, are limited though weight loss is an important strategy to improve outcomes in either disease. Glucagon-like peptide 1 receptor agonist (GLP1-RA) present a novel option to treat this dual disease by their salutary effects on glycaemic control and weight reduction.Methods: Eight randomized controlled trials on T2D and NAFLD from the Cochrane Library, Embase, and PubMed were included in this meta-analysis. The Comprehensive Meta-Analysis Software version 3 was used to calculate the effect size.Result: In a pooled population of 615 patients—297 on GLP1-RA and 318 in the control arm, GLP1-RA produced a significant improvement in alanine aminotransferase [standardised mean difference (SDM), -0.56, 95%CI, - 0.88 to -0.25, P<0.01], aspartate aminotransferase (SDM, -0.44, SE, 95%CI, -0.64 to -0.24, P<0.01), gamma glutaryl transaminase (SDM, -0.59, 95%CI, -0.86 to -0.34, P<0.01) and reduction in liver fat content (LFC) (SDM, -0.43, 95%CI, - 0.74 to -0.13, P<0.01), as well as glycosylated haemoglobin (SDM, -0.40, 95% CI, -0.61 to -0.19, P<0.01) and weight (SDM, -0.66, 95% CI, -0.88 to -0.45, P<0.01), in comparison to standard of care or placebo. Significant improvement in biopsy resolution was also seen in the GLP1-RA arm (Rate Ratio, 6.59, 95%CI, 2.67 to 16.29, P<0.01). Conclusion: This is possibly the first meta-analysis conducted exclusively in patients with T2D and NAFLD which presents a strong signal that GLP1-RA, improve liver function and histology by improving glycaemia, reducie body weight and hepatic fat, which in turn reduces hepatic inflammation.Trial Registration: PROSPERO (ID: CRD42021228824)
A Meta-Analysis of the Effects of Glucagon-Like-Peptide 1 Receptor Agonist (GLP1-RA) in Nonalcoholic Fatty Liver Disease (NAFLD) With Type 2 Diabetes (T2D)
