PMID- 34956080
OWN - NLM
STAT- MEDLINE
DCOM- 20220217
LR  - 20220217
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 12
DP  - 2021
TI  - Efficacy and Safety of GLP-1 Receptor Agonists in Patients With Type 2 Diabetes 
      Mellitus and Non-Alcoholic Fatty Liver Disease: A Systematic Review and 
      Meta-Analysis.
PG  - 769069
LID - 10.3389/fendo.2021.769069 [doi]
LID - 769069
AB  - The prevalence of non-alcoholic fatty liver disease (NAFLD) in patients with type 
      2 diabetes mellitus (T2DM) is increasing and there is an urgent need for new 
      treatment strategy to prevent progression of hepatic steatosis and fibrosis. We 
      have performed a systematic review and meta-analysis of randomized controlled 
      trials (RCTs) to evaluate the efficacy and safety of glucagon-like peptide-1 
      receptor agonists (GLP-1RAs) in the treatment of hepatic steatosis and fibrosis 
      in patients with T2DM and NAFLD. The PubMed, Web of Science, Scopus, Embase and 
      Cochrane Central Register of Controlled Trials databases were searched for 
      articles that met the eligibility criteria to explore the efficacy and safety of 
      GLP-1RAs in patients with T2DM and NAFLD. We assessed pooled data using a 
      random/fixed-effects model according to the I(2) and p-values. Eight trials that 
      included a total of 468 participants were eligible for inclusion in the review. 
      For primary outcomes, administration of GLP-1RAs significantly decreased the 
      content of intrahepatic adipose (IHA)[p=0.007, weight mean difference (WMD) 
      -3.01, 95% confidence interval (CI) -4.75, -1.28], subcutaneous adipose tissue 
      (SAT) (p<0.00001,WMD -28.53,95%CI -68.09,-26.31), and visceral adipose tissue 
      (VAT) (p<0.0001,WMD -29.05,95%CI -42.90,-15.9). For secondary outcomes, GLP-1RAs 
      produced a significant decrease in levels of alanine 
      aminotransferase(ALT)(p=0.02, WMD -3.82, 95%CI -7.04, -0.60), aspartate 
      aminotransferase (AST) (p=0.03, WMD -2.4, 95%CI -4.55,-0.25, I(2) = 49%), body 
      weight (p<0.00001,WMD -3.48,95%CI -4.58,-2.37), body mass index (p<0.00001,WMD 
      -1.07,95%CI -1.35,-0.78), circumference waist (p=0.0002,WMD -3.87, 95%CI -5.88, 
      -1.86) fasting blood glucose (p=0.02, WMD -0.35, 95%CI -0.06, -0.05), HbA(1c) 
      (p<0.00001,WMD -0.39,95%CI -0.56,-0.22), HoMA-IR(p=0.005, WMD-1.51, 
      95%CI-0.87,-0.16), total cholesterol (p=0.0008, WMD -0.31, 95%CI -0.48, 0.13) and 
      triglycerides (p=0.0008, WMD -0.27, 95%CI -0.43,-0.11) in comparison with the 
      control regimens. The main adverse events associated with GLP-1RAs included 
      mild-to-moderate gastrointestinal discomfort and nonsense hypoglycemia that 
      resolved within a few weeks. GLP-1RAs were an effective treatment that improved 
      intrahepatic visceral and subcutaneous adipose tissue, inflammatory markers, the 
      anthropometric profiles and some metabolic indices in patients with T2DM and 
      NAFLD, GLP-1RAs could be considered for use in these if there are no 
      contraindications. Further studies are needed to understand the direct and 
      indirect effects of GLP-1RAs on NAFLD and the potential mechanism via which they 
      prevent its progression. Systematic Review Registration: PROSPERO, identifier 
      CRD42021265806.
CI  - Copyright (c) 2021 Zhu, Xu, Zhang, Mu, Shi, Chen, Wu and Li.
FAU - Zhu, Yuan
AU  - Zhu Y
AD  - Department of General Practice, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Xu, Jiao
AU  - Xu J
AD  - Department of General Practice, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Zhang, Dong
AU  - Zhang D
AD  - Department of General Practice, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Mu, Xingyu
AU  - Mu X
AD  - Department of General Practice, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Shi, Yi
AU  - Shi Y
AD  - Department of General Practice, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Chen, Shangtao
AU  - Chen S
AD  - Department of General Practice, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Wu, Zengxiang
AU  - Wu Z
AD  - Department of General Practice, West China Hospital of Sichuan University, 
      Chengdu, China.
FAU - Li, Shuangqing
AU  - Li S
AD  - Department of General Practice, West China Hospital of Sichuan University, 
      Chengdu, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20211209
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - 0 (Glucagon-Like Peptide-1 Receptor)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Diabetes Mellitus, Type 2/complications/*drug therapy
MH  - Glucagon-Like Peptide-1 Receptor/*agonists
MH  - Humans
MH  - Hypoglycemic Agents/adverse effects/*therapeutic use
MH  - Non-alcoholic Fatty Liver Disease/*complications
MH  - Treatment Outcome
PMC - PMC8696030
OTO - NOTNLM
OT  - GLP-1 receptor agonists
OT  - hepatic fibrosis
OT  - intrahepatic adipose
OT  - meta-analysis
OT  - non-alcoholic fatty liver disease
OT  - type 2 diabetes
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/12/28 06:00
MHDA- 2022/02/19 06:00
PMCR- 2021/01/01
CRDT- 2021/12/27 06:24
PHST- 2021/09/01 00:00 [received]
PHST- 2021/11/23 00:00 [accepted]
PHST- 2021/12/27 06:24 [entrez]
PHST- 2021/12/28 06:00 [pubmed]
PHST- 2022/02/19 06:00 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2021.769069 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2021 Dec 9;12:769069. doi: 
      10.3389/fendo.2021.769069. eCollection 2021.