Published online Aug 27, 2020. doi: 10.4254/wjh.v12.i8.493
Peer-review started: May 16, 2020
First decision: April 26, 2020
Revised: May 2, 2020
Accepted: June 20, 2020
Article in press: June 20, 2020
Published online: August 27, 2020
Non-alcoholic fatty liver disease (NAFLD) is the predominant cause of chronic liver disease worldwide. NAFLD progresses in some cases to non-alcoholic steatohepatitis (NASH), which is characterized, in addition to liver fat deposition, by hepatocyte ballooning, inflammation and liver fibrosis, and in some cases may lead to hepatocellular carcinoma. NAFLD prevalence increases along with the rising incidence of type 2 diabetes mellitus (T2DM). Currently, lifestyle interventions and weight loss are used as the major therapeutic strategy in the vast majority of patients with NAFLD. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used in the management of T2DM and do not have major side effects like hypoglycemia. In patients with NAFLD, the GLP-1 receptor production is down-regulated. Recently, several animal and human studies have emphasized the role of GLP-1RAs in ameliorating liver fat accumulation, alleviating the inflammatory environment and preventing NAFLD progression to NASH. In this review, we summarize the updated literature data on the beneficial effects of GLP-1RAs in NAFLD/NASH. Finally, as GLP-1RAs seem to be an attractive therapeutic option for T2DM patients with concomitant NAFLD, we discuss whether GLP-1RAs should represent the first line pharmacotherapy for these patients.
Core tip: The strong relationship between non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus points to a need to evaluate the therapeutic potential of antidiabetic drugs in patients with NAFLD. Accordingly, glucagon-like peptide-1 receptor agonists, which are well-tolerated antidiabetic agents with no risk of hypoglycemia, seem to be a very appealing therapeutic option for type 2 diabetes mellitus patients with NAFLD. Herein, based on data from animal studies and clinical trials, we discuss the beneficial impact of glucagon-like peptide-1 receptor agonists on NAFLD.