Endocrine Abstracts

Background and Aims: Non-alcoholic fatty liver disease (NAFLD), a leading cause of cirrhosis and liver cancer, is increasing worldwide due to rising obesity rates, particularly in Asia. Weight loss induced with diet and exercise decreases hepatic steatosis and inflammation, but requires greater efforts to sustain compared to medication. We therefore aimed to compare the effects of liraglutide, a glucagon-like peptide-1 agonist which induces weight loss, on hepatic steatosis and inflammation in obese Asian adults with NAFLD with intensive lifestyle modification.

Methods: 22 abdominally obese Asian (mean BMI 33.6±3.9 kg/m², mean waist circumference WC 108.5±10.6 cm) non-diabetic normotensive adults with NAFLD, as diagnosed by a hepatologist based on elevated serum alanine transaminase (ALT) and aspartate transaminase (AST) levels and liver fat fraction >5% using magnetic resonance imaging (MRI) in the absence of other causes of hepatic steatosis and transaminitis, were randomized to supervised dieting (restriction by 400 kcal/day) plus moderate-intensity exercise (200 minutes/week) to induce ≥5% weight loss (DE group, n=11) or liraglutide 3 mg daily (LI group, n=11) for 26 weeks. Insulin resistance was estimated by homeostasis model assessment (HOMA-IR) and liver shear stiffness with MRI elastography.

Results: At 26 weeks, both DE and LI groups had significant (P<0.01) and similar reductions in weight (−3.1±2.9 vs −3.6±2.4 kg), WC (−4.4±3.2 vs −5.7±3.9 cm), liver fat (−9.5±13.8 vs −7.7±7.3%), liver stiffness (−0.22±0.20 vs −0.32±0.25 kPa), ALT (−42±34 vs −43±39 U/l), AST (−21±16 vs −26±25 U/l) and HOMA-IR (−2.87±2.67 vs −3.12±2.40).

Conclusion: Once-daily liraglutide is as effective as intensive lifestyle modification for decreasing hepatic steatosis, inflammation and stiffness in obese Asian adults with NAFLD.