Changes in Transient Elastography with Glucagon-Like Peptide-1 Receptor Agonist Use in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Real-World Retrospective Analysis

Jun 13, 2024Metabolic syndrome and related disorders

Changes in Liver Stiffness with Diabetes Drug Use in Fatty Liver Disease Linked to Metabolic Problems

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Abstract

GLP-1 receptor agonist treatment led to a weight loss of -8.1 kg in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).

Significant reductions in body mass index (BMI) were observed, with a decrease of -2.9 kg/m in GLP-1RA users compared to -1.3 kg/m in nonusers.
Improvements in liver function tests were noted, including a decrease in alanine aminotransferase by -15.0 IU/L and aspartate aminotransferase by -5.0 IU/L among GLP-1RA users.
Glycated hemoglobin (HbA1c) levels decreased by -0.7% in GLP-1RA users, contrasting with a slight increase of 0.1% in nonusers.
A notable improvement in controlled attenuation parameter (CAP) of -59.9 dB/m was recorded for those using GLP-1RAs, compared to -29.1 dB/m in nonusers.
Responders to GLP-1RA treatment showed further enhancements in weight, BMI, diastolic blood pressure, HbA1c, and liver stiffness measurement (LSM).
Changes in CAP greater than 38 dB/m were associated with improvements in LSM and other metabolic parameters, indicating potential benefits of monitoring with vibration-controlled transient elastography.

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Current guidelines recommend the use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD), especially in patients with comorbid diabetes and obesity. This study investigated the effects of GLP-1RAs on hepatic steatosis and fibrosis in patients with MASLD, as measured by changes in vibration-controlled transient elastography (VCTE) and other clinical parameters in a real-world clinical setting.We conducted a single-center, retrospective analysis of 96 patients with MASLD from a multidisciplinary care clinic who completed VCTE at baseline and follow-up within 6-24 months to compare changes in controlled attenuation parameter (CAP) and liver stiffness measurement (LSM), as well as other metabolic markers, between GLP-1RA users and nonusers using two-sample-tests and Wilcoxon rank-sum tests. We also assessed whether improvements in hepatic steatosis, defined as a change in CAP >38 dB/m as previously described in the literature, were associated with improvement in fibrosis.GLP-1RA use resulted in significant improvements in weight (-8.1 kg vs. -3.5 kg,= 0.009), body mass index (BMI) (-2.9 kg/mvs. -1.3 kg/m,= 0.012), alanine aminotransferase (-15.0 IU/L vs. -4.0 IU/L,= 0.017), aspartate aminotransferase (-5.0 IU/L vs. -1.0 IU/L,= 0.021), glycated hemoglobin (HbA1c) (-0.7% vs. 0.1%,= 0.019), and CAP (-59.9 dB/m vs. -29.1 dB/m,= 0.016). Responders also had significant improvements in weight (-9.2 kg vs. -1.9 kg,< 0.001), BMI (-3.3 kg/mvs. -0.7 kg/m,< 0.001), diastolic blood pressure (-6.1 mmHg vs. -0.7 mmHg,= 0.028), HbA1c (-0.8% vs. 0.3%,< 0.001), and LSM (-1.5 kPa vs. 0.1 kPa,< 0.001).Patients with MASLD treated with GLP-1RAs showed significant improvements in hepatic steatosis and multiple other metabolic parameters, with weight loss as the proposed mechanism for this liver improvement. In addition, change in CAP >38 dB/m was associated with improvements in LSM and other metabolic parameters, suggesting the clinical utility of VCTE in the surveillance of MASLD. Introduction: Methods: Results: Conclusions: t P P P P P P P P P P P2 2 2 2

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Changes in Transient Elastography with Glucagon-Like Peptide-1 Receptor Agonist Use in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Real-World Retrospective Analysis

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