Glucagon-like peptide-1 receptor agonists in metabolic dysfunction-associated steatotic liver disease: a narrative review

Abstract

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the
most common chronic liver diseases worldwide and is strongly linked to obesity and type 2
diabetes mellitus. Glucagon-like peptide-1 (GLP-1) receptor agonists have gained attention
because of their hepatoprotective and cardiometabolic effects.
Aim: This narrative review summarizes current evidence on GLP-1 receptor agonists in the
treatment of MASLD and metabolic dysfunction-associated steatohepatitis (MASH).
Materials and methods: A literature review was conducted using PubMed, Scopus and Google
Scholar. Included studies comprised clinical trials, randomized controlled trials, meta-analyses,
review articles and international guidelines published between 2021 and 2025.
Results: Evidence suggests that GLP-1 receptor agonists, especially semaglutide and
liraglutide, reduce hepatic steatosis, insulin resistance, body weight and inflammatory activity
in patients with MASLD or MASH. Several studies demonstrated improvements in liver
histology and non-invasive fibrosis markers, although antifibrotic effects were less consistent
in advanced cirrhosis. These agents also improved glycemic control and cardiovascular risk
factors, with an acceptable safety profile.
Conclusions: GLP-1 receptor agonists appear to be a promising therapeutic option for MASLD
and MASH. However, further long-term randomized studies are required to confirm their
effects on fibrosis and liver-related outcomes.