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已发表论文
胰高糖素样肽-1 受体激动剂对代谢功能障碍相关脂肪性肝炎肝脏相关结局、实验室和生理参数的影响：一项系统综述和荟萃分析
Authors Wang MJ, Jiang YN, Li PP, Wu YJ
Received 16 September 2025
Accepted for publication 8 January 2026
Published 11 February 2026 Volume 2026:19 565093
DOI https://doi.org/10.2147/DMSO.S565093
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Liang Wang
Mei-jun Wang, Yu-nuo Jiang, Pei-pei Li, Yuan-Jie Wu
Key Laboratory of Xin’an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei, 230038, People’s Republic of China
Correspondence: Pei-pei Li; Yuan-Jie Wu, Key Laboratory of Xin’an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei, 230038, People’s Republic of China, Email Peipeilitcm@126.com; anhuiwuyuanjie@126.com
Background: Metabolic dysfunction-associated steatohepatitis (MASH) is a leading cause of chronic liver disease globally, with limited treatment options. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show potential for MASH due to their metabolic benefits, but evidence on histological outcomes remains inconclusive.
Methods: We conducted a PRISMA 2020-compliant systematic review and meta-analysis, including 25 randomized controlled trials (RCTs, n=2481). Primary outcomes were resolution of MASH without fibrosis worsening and fibrosis improvement without steatohepatitis worsening. Secondary outcomes included anthropometric and biochemical parameters. Risk of bias was assessed via ROB 2, and evidence certainty via GRADE. Trial sequential analysis (TSA) addressed random errors.
Results: GLP-1 RAs significantly increased MASH resolution without fibrosis worsening (OR=4.04; 95% CI [2.69– 6.05]; P< 0.00001; 7 RCTs, n=1456). No significant improvement in fibrosis was observed (OR=1.54; 95% CI [0.95– 2.48]; P=0.08; 5 RCTs, n=1277). Secondary outcomes showed reduced BMI (MD=− 0.52 kg/m2; P=0.05) but no significant changes in weight, waist circumference, liver enzymes, or lipids. TSA confirmed sufficient evidence for MASH resolution (RIS=197) but not fibrosis improvement (RIS=1693). GRADE indicated high certainty for primary outcomes.
Conclusion: GLP-1 RAs promote MASH resolution but do not significantly improve fibrosis. Their benefits appear to be driven by metabolic mechanisms rather than direct antifibrotic effects. Larger RCTs targeting fibrosis endpoints are warranted.
Trial Registration: The protocol for our meta-analysis and systematic review was registered and recorded in PROSPERO (registration no. CRD420251090801).
Keywords: glucagon-like peptide-1 receptor agonists, GLP-1 RAs, metabolic dysfunction-associated steatohepatitis, meta-analysis
Key Laboratory of Xin’an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei, 230038, People’s Republic of China
Correspondence: Pei-pei Li; Yuan-Jie Wu, Key Laboratory of Xin’an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei, 230038, People’s Republic of China, Email Peipeilitcm@126.com; anhuiwuyuanjie@126.com
Background: Metabolic dysfunction-associated steatohepatitis (MASH) is a leading cause of chronic liver disease globally, with limited treatment options. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show potential for MASH due to their metabolic benefits, but evidence on histological outcomes remains inconclusive.
Methods: We conducted a PRISMA 2020-compliant systematic review and meta-analysis, including 25 randomized controlled trials (RCTs, n=2481). Primary outcomes were resolution of MASH without fibrosis worsening and fibrosis improvement without steatohepatitis worsening. Secondary outcomes included anthropometric and biochemical parameters. Risk of bias was assessed via ROB 2, and evidence certainty via GRADE. Trial sequential analysis (TSA) addressed random errors.
Results: GLP-1 RAs significantly increased MASH resolution without fibrosis worsening (OR=4.04; 95% CI [2.69– 6.05]; P< 0.00001; 7 RCTs, n=1456). No significant improvement in fibrosis was observed (OR=1.54; 95% CI [0.95– 2.48]; P=0.08; 5 RCTs, n=1277). Secondary outcomes showed reduced BMI (MD=− 0.52 kg/m2; P=0.05) but no significant changes in weight, waist circumference, liver enzymes, or lipids. TSA confirmed sufficient evidence for MASH resolution (RIS=197) but not fibrosis improvement (RIS=1693). GRADE indicated high certainty for primary outcomes.
Conclusion: GLP-1 RAs promote MASH resolution but do not significantly improve fibrosis. Their benefits appear to be driven by metabolic mechanisms rather than direct antifibrotic effects. Larger RCTs targeting fibrosis endpoints are warranted.
Trial Registration: The protocol for our meta-analysis and systematic review was registered and recorded in PROSPERO (registration no. CRD420251090801).
Keywords: glucagon-like peptide-1 receptor agonists, GLP-1 RAs, metabolic dysfunction-associated steatohepatitis, meta-analysis