Endocrine Abstracts

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease and has an estimated prevalence of 25–30% worldwide, rising to 90% in morbidly obese patients and to 60% in patients with type 2 diabetes (T2D). The mortality related to NAFLD, attributed to hepatic and extra-hepatic diseases, continues to increase. Moreover, T2D is an aggravating factor for NAFLD, as it increases the risk of developing non-alcoholic steatohepatitis (NASH), liver fibrosis, cirrhosis and hepatocellular carcinoma. Nevertheless, there is currently no specific pharmacologic treatment for NAFDL and its only validated treatment is weight loss. A number of studies of animal models and human trials have provided evidence of a beneficial effect of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on liver fat content and NASH. These data suggest that this treatment could represent a new alternative for NAFLD management. The studies evaluating the effects of GLP-1RAs on NAFLD will be described and discussed. The mechanisms underlying these effects will be analyzed. Indeed, the effects of GLP-1RAs on weight reduction and lipid metabolism seem to be the two main mechanisms explaining the decrease in liver fat content with this treatment. However, larger studies of longer duration with complete histological outcomes are needed to determine the precise effect of GLP-1RAs in NASH improvement and to assess the efficacy of GLP-1RAs according to the presence or not of type 2 diabetes.