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

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 -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.