Poster Presentation ESA-SRB-ANZOS 2025 in conjunction with ENSA

Improvement in metabolic dysfunction-associated steatotic liver disease in overweight and obese adults with incretin analogue pharmacotherapy (128408)

Julia Gordon 1 , Brooke Hughes 2 , Judy Chen 3 , Nicholas Gorginian 4 , Thaw Htet 3 , Juliana Chen 5 , Veronica Preda 6
  1. Macquarie University Clinical School, Macquarie University Hospital, Sydney, New South Wales, Australia
  2. Macquarie University Clinical School, Macquarie University Hospital, Sydney, New South Wales, Australia
  3. Department of Endocrinology, Macquarie University Hospital, Sydney, New South Wales, Australia
  4. Macquarie University Hospital, Sydney, New South Wales, Australia
  5. Department of Nutrition and Dietetics, University of Sydney, Sydney, New South Wales, Australia
  6. Department of Endocrinology, Macquarie University Hospital, Sydney, New South Wales, Australia

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease and the leading cause of liver-related morbidity and mortality. Its burden lies in the risk of progression to decompensated cirrhosis and hepatocellular carcinoma. While GLP-1 receptor agonists show promising metabolic and hepatoprotective effects in clinical trials, real-world data in overweight and obese populations remain limited. The aim of this study is to evaluate the effect of incretin analogues (semaglutide, liraglutide, tirzepatide) on hepatic steatosis in overweight or obese adults with a diagnosis of MASLD established by ultrasonography +/- elastography.

In this retrospective cohort study, we reviewed serial ultrasonography reports from overweight or obese patients (BMI ≥ 25 kg/m2) with MASLD obtained before and after pharmacotherapy with semaglutide (n = 18), liraglutide (n = 3), or tirzepatide (n = 7) for an average of 18 months, under the care of an endocrinologist. The primary outcome was the change in hepatic steatosis severity, graded on a semi-quantitative ordinal scale (mild = 1, moderate = 2, severe = 3). Secondary outcomes included changes in fasting lipid profile, and HbA1c.

The mean hepatic steatosis grade improved from 2.03 to 1.48 following pharmacotherapy, with a statistically significant mean reduction of 0.55 (95% CI [0.19 to 0.93], p = 0.004). In addition, a significant reduction in body weight was observed, with a mean loss of 9.97 kg (95% CI [6.03 to 13.92], p < 0.001). Among cardiometabolic parameters, HbA1c showed a mean reduction of 0.8% (95% CI: 0.1 to 1.5; p = 0.009), while changes in the fasting lipid profile were not statistically significant.

These real-world findings suggest that GLP-1 receptor agonists and dual GLP-1/GIP receptor agonists are associated with improvements in hepatic steatosis and weight-loss in overweight and obese adults with MASLD, supporting their potential role in the pharmacological management of MASLD.