A Growing Health Crisis
Metabolic dysfuncion-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) are quickly becoming top global health concerns.
Currently, no treatment with FDA approval exists for these progressive liver diseases linked to obesity and type 2 diabetes. But GLP-1 receptor agonists (GLP-1 RAs) holds potential in this regard.
What Are GLP-1 RAs?
GLP-1 RAs are medication that help regulate blood sugar and promote weight loss in people with type 2 diabetes. For example, drugs like semaglutide (Wegovy, Ozempic) and liraglutide are popular for their metabolic effects.
Interestingly, researchers are now exploring their potential benefits for MASLD and MASH as well.
Promising Results for MASLD and MASH
In particular, recent studies show that GLP-1 RAs may reduce liver fat and inflammation in MASH and MASLD patients. For instance, a study in Scientific Reports found that semaglutide significantly improved liver enzyme levels in patients with fatty liver disease.
Furthermore, a retrospective analysis showed better outcomes for liver health among patients using GLP-1 RAs over other diabetes drugs. As a result, liver specialists are taking notice.
How They Help MASLD and MASH
GLP-1 RAs appear to target multiple pathways involved in liver damage. First, they reduce insulin resistance—a major driver of liver fat accumulation.
Second, they curb appetite and promote weight loss, which is key for improving MASH and MASLD. Additionally, GLP-1 RAs may increase fatty acid oxidation and reduce lipogenesis in the liver.
In fatty acid oxidation, the body breaks down fatty acids to create energy. Meanwhile, lipogenesis refers to the process where the body produces fat from carbohydrates and sometimes, proteins.
MASLD, MASH Treatment Promise
Emerging science suggests these drugs interact with pathways like FXR and LXR that regulate liver inflammation and bile acid metabolism. This may explain why liver enzymes drop and fibrosis appears to slow in treated patients. Fibrosis refers to how the body lays down too much scar tissue.
Moreover, patients on semaglutide showed decreased markers of liver cell injury in a recent clinical trial.
Safe for the Liver?
People with early-stage liver disease typically tolerate GLP-1 RAs well. In particular, nausea and diarrhea are common side effects. But these often fade over time.
More importantly, researchers did not report major liver-related adverse events in the latest trials. Thus, GLP-1 RAs’ safety profile appears to be acceptable for long-term use.
Looking Ahead
Drugmakers like Novo Nordisk are expanding trials of GLP-1 RAs specifically for liver diseases like MASLD. Although results are still early, enthusiasm is building.
If ongoing studies confirm these benefits, then GLP-1 RAs could become frontline therapy for MASLD and MASH. Meanwhile, researchers stress the need for personalized treatment strategies.
Overall, GLP-1 receptor agonists may soon do more than lower blood sugar—they could also protect the liver. As research continues, experts may repurpose these familiar drugs for one of the world’s most common liver conditions. Ultimately, this could be a game-changer for millions with fatty liver disease.
Photo: Freepik
