GLP‐1 Receptor Agonist Effects on Lipid and Liver Profiles in Patients with Nonalcoholic Fatty Liver Disease: Systematic Review and Meta‐Analysis

Abstract

Aims . This meta‐analysis of randomized placebo‐controlled clinical trials assessed the effect of glucose‐like peptide‐1‐receptor agonists (GLP‐1RA) on the lipid profile and liver enzymes in patients with nonalcoholic fatty liver disease (NAFLD). Materials and Methods . Randomized placebo‐controlled trials investigating GLP‐1RA on the lipid profile and liver enzymes in patients with NAFLD were searched in PubMed‐Medline, Scopus, Web of Science, and Google Scholar databases (from inception to January 2020). A random‐effects model and a generic inverse variance method were used for quantitative data synthesis. Sensitivity analysis was conducted. Weighted random‐effects meta‐regression was performed on potential confounders on lipid profile and liver enzyme concentrations. Results . 12 studies were identified (12 GLP‐1RA arms; 677 subjects) that showed treatment with GLP‐1RA reduced alanine transaminase (ALT) concentrations (WMD = −10.14, 95%CI = [−15.84, −0.44], P < 0.001), gamma‐glutamyl transferase (GGT) (WMD = −11.53, 95%CI = [−15.21,−7.85], P < 0.001), and alaline phosphatase (ALP) (WMD = −8.29, 95%CI = [−11.34, −5.24], P < 0.001). Aspartate aminotransferase (AST) (WMD = −2.95, 95% CI = [−7.26, 1.37], P = 0.18) was unchanged. GLP‐1 therapy did not alter triglycerides (TC) (WMD = −7.07, 95%CI = [−17.51, 3.37], P = 0.18), total cholesterol (TC) (WMD = −1.17 (−5.25, 2.91), P = 0.57), high‐density lipoprotein (HDL‐C) (WMD = 0.97, 95%CI = [−1.63, 3.58], P = 0.46), or low‐density lipoprotein (LDL‐C) (WMD = −1.67, 95%CI = [−10.08, 6.74], P = 0.69) in comparison with controls. Conclusion . The results of this meta‐analysis suggest that GLP‐1RA treatment significantly reduces liver enzymes in patients with NAFLD, but the lipid profile is unaffected.

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