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短期利拉鲁肽治疗对非酒精性脂肪性肝病合并代谢功能障碍患者肝纤维化无创指标的影响

Impact of Short-Term Liraglutide Therapy on Non-Invasive Markers of Liver Fibrosis in Patients with MASLD.

作者信息

Bołdys Aleksandra, Borówka Maciej, Bułdak Łukasz, Okopień Bogusław

机构信息

Department of Internal Medicine and Clinical Pharmacology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland.

出版信息

Metabolites. 2025 Jul 31;15(8):510. doi: 10.3390/metabo15080510.

Abstract

: Affecting close to one-third of the global population, metabolic dysfunction-associated steatotic liver disease (MASLD) is a highly prevalent chronic liver disorder linked to metabolic risk factors such as obesity and insulin resistance. Liver fibrosis is a key determinant of prognosis, and its progression increases the risk of liver-related and overall mortality. This exploratory research evaluated the potential impact of a 3-month intervention involving dietary counseling and liraglutide therapy on liver fibrosis and related metabolic markers in patients with MASLD and obesity without diabetes. : In this prospective, single-arm exploratory intervention, 28 adult patients with MASLD and obesity received structured dietary counseling and daily subcutaneous liraglutide for 12 weeks. Liver fibrosis was assessed using non-invasive indices (FIB-4, APRI, BARD, ELF) and transient elastography performed with the FibroScan device (Echosens, Paris, France). : After 3 months, a significant reduction in liver stiffness (-7.14%, < 0.05) and ELF score (from 6.71 to 6.63; -1.2%, < 0.05) was observed. APRI ( = 0.06) and FIB-4 ( = 0.09) showed trends toward improvement, while the BARD score and AST/ALT ratio remained unchanged. Short-term liraglutide therapy combined with lifestyle modification may improve early-stage liver fibrosis in patients with MASLD and obesity, as indicated by reductions in liver stiffness and ELF score. These preliminary findings highlight the potential of advanced non-invasive fibrosis markers in monitoring treatment response. However, as an exploratory study, results should be interpreted with caution, and larger, long-term trials are needed to confirm these observations and evaluate efficacy in patients with more advanced fibrosis stages.

摘要

代谢功能障碍相关脂肪性肝病(MASLD)影响着全球近三分之一的人口,是一种与肥胖和胰岛素抵抗等代谢风险因素相关的高度流行的慢性肝病。肝纤维化是预后的关键决定因素,其进展会增加肝脏相关和全因死亡风险。本探索性研究评估了为期3个月的饮食咨询和利拉鲁肽治疗干预对无糖尿病的MASLD和肥胖患者肝纤维化及相关代谢指标的潜在影响。:在这项前瞻性单臂探索性干预研究中,28例成年MASLD和肥胖患者接受了为期12周的结构化饮食咨询和每日皮下注射利拉鲁肽治疗。使用非侵入性指标(FIB-4、APRI、BARD、ELF)和用FibroScan设备(法国巴黎Echosens公司)进行的瞬时弹性成像评估肝纤维化。:3个月后,观察到肝脏硬度显著降低(-7.14%,<0.05)和ELF评分降低(从6.71降至6.63;-1.2%,<0.05)。APRI(=0.06)和FIB-4(=0.09)显示出改善趋势,而BARD评分和AST/ALT比值保持不变。短期利拉鲁肽治疗联合生活方式改变可能改善MASLD和肥胖患者的早期肝纤维化,肝脏硬度和ELF评分降低表明了这一点。这些初步发现突出了先进的非侵入性纤维化标志物在监测治疗反应方面的潜力。然而,作为一项探索性研究,结果应谨慎解读,需要进行更大规模的长期试验来证实这些观察结果,并评估在更晚期纤维化阶段患者中的疗效。

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