The effects of liraglutide on liver enzymes and metabolic factors in patients with nonalcoholic steatohepatitis: a meta-analysis of randomized controlled trials.

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY Przegla̜d Gastroenterologiczny Pub Date : 2023-01-01 Epub Date: 2022-01-23 DOI:10.5114/pg.2022.112775
Adnan Malik, Waseem Amjad, Faisal Inayat, Mahum Nadeem, Simcha Weissman, Muhammad Imran Malik, Ans Ahmad Jajja, Ahmad Khan, James H Tabibian
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Abstract

Introduction: Nonalcoholic steatohepatitis (NASH) is the most common cause of chronic liver disease, but no drug therapies have been approved to date. While glucagon-like peptide-1 (GLP-1) analogues may help in the management, the existing evidence remains conflicting.

Aim: This meta-analysis aims to elucidate the efficacy of liraglutide in patients with NASH.

Material and methods: We searched 4 databases for randomized controlled trials assessing the efficacy of liraglutide in patients with NASH. We analysed continuous outcomes using the mean difference (MD) and relative 95% confidence interval (CI), while dichotomous outcomes were analysed using the risk ratio (RR) and relative 95% CI. Primary endpoints included alanine aminotransferase (ALT) (IU/l), aspartate aminotransferase (AST) (IU/l), alkaline phosphatase (ALP) (IU/l), and γ-glutamyl transferase (GGT) (IU/l). Secondary outcomes were body mass index (BMI) (kg/m2), waist circumference (cm), total cholesterol (TC) (mmol/l), triglyceride (TG) (mmoll), high-density lipoprotein (HDL) (mmol/l), low-density lipoprotein (LDL) (mmol/l), and glycated hemoglobin (HbA1c) (%).

Results: A total of 5 clinical trials were included. The analysis showed that liraglutide is effective in increasing HDL (MD = +0.10 (-0.18, -0.02), p = 0.02) and reducing LDL levels in blood (MD = -0.29 (-0.56, -0.02), p = 0.04). No significant difference was noted in levels of ALT (MD = 2.66 (-1.56, 6.87), p = 0.22), AST (MD = -1.99 (-5.70, 1.72), p = 0.29), GGT (MD = 5.02 (-0.86, 10.90), p = 0.09), ALP (MD = -5.16 (-11.90, 1.59), p = 0.13), TC (MD = -0.31 (-0.65, 0.03), p = 0.07), or TG (MD = -0.14 (-0.53, 0.25), p = 0.48). The HbA1c (%) level was found to be significantly reduced in the liraglutide arm (MD = -0.62 (-0.88, -0.36), p < 0.01).

Conclusions: Liraglutide effectively improves the lipid profile in patients with NASH.

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利拉鲁肽对非酒精性脂肪性肝炎患者肝酶和代谢因素的影响:随机对照试验荟萃分析。
简介非酒精性脂肪性肝炎(NASH)是慢性肝病最常见的病因,但至今尚未批准任何药物疗法。虽然胰高血糖素样肽-1(GLP-1)类似物可能有助于治疗,但现有证据仍存在冲突。目的:本荟萃分析旨在阐明利拉鲁肽对非酒精性脂肪性肝炎患者的疗效:我们在 4 个数据库中检索了评估利拉鲁肽对 NASH 患者疗效的随机对照试验。我们使用平均差 (MD) 和相对 95% 置信区间 (CI) 分析连续性结果,而使用风险比 (RR) 和相对 95% CI 分析二分法结果。主要终点包括丙氨酸氨基转移酶(ALT)(IU/l)、天门冬氨酸氨基转移酶(AST)(IU/l)、碱性磷酸酶(ALP)(IU/l)和γ-谷氨酰转移酶(GGT)(IU/l)。次要结果包括体重指数(BMI)(kg/m2)、腰围(cm)、总胆固醇(TC)(mmol/l)、甘油三酯(TG)(mmoll)、高密度脂蛋白(HDL)(mmol/l)、低密度脂蛋白(LDL)(mmol/l)和糖化血红蛋白(HbA1c)(%):结果:共纳入了 5 项临床试验。分析表明,利拉鲁肽能有效增加高密度脂蛋白(MD = +0.10 (-0.18, -0.02),P = 0.02),降低血液中的低密度脂蛋白水平(MD = -0.29 (-0.56, -0.02),P = 0.04)。ALT(MD = 2.66(-1.56,6.87),p = 0.22)、AST(MD = -1.99 (-5.70,1.72),p = 0.29)、GGT(MD = 5.02(-0.86,10.90),P = 0.09)、ALP(MD = -5.16(-11.90,1.59),P = 0.13)、TC(MD = -0.31(-0.65,0.03),P = 0.07)或 TG(MD = -0.14(-0.53,0.25),P = 0.48)。利拉鲁肽治疗组的 HbA1c (%) 水平显著降低(MD = -0.62 (-0.88, -0.36),p < 0.01):结论:利拉鲁肽能有效改善NASH患者的血脂状况。
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来源期刊
Przegla̜d Gastroenterologiczny
Przegla̜d Gastroenterologiczny GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
2.20
自引率
7.70%
发文量
50
审稿时长
6-12 weeks
期刊介绍: Gastroenterology Review is a journal published each 2 months, aimed at gastroenterologists and general practitioners. Published under the patronage of Consultant in Gastroenterology and Polish Pancreatic Club.
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