Effects of glucagon-like peptide-1 receptor agonists and dual glucagon-like peptide-1 receptor agonists/glucose-dependent insulinotropic polypeptide on liver stiffness and steatosis evaluated through Fibroscan®: a systematic review and meta-analysis.

Metabolically associated fatty liver disease (MASLD) is highly prevalent among individuals with obesity and type 2 diabetes. Glucagon-like peptide-1 receptor agonists (GLP1-RA) and glucagon-like peptide-1 receptor agonists/glucose-dependent insulinotropic polypeptide (GLP1-RA/GIP) dual agonists have demonstrated favorable effects on liver health. Liver steatosis and stiffness can be noninvasively assessed using transient elastography with Fibroscan®. However, evidence regarding the impact of incretin therapy on these elastographic outcomes remains inconsistent across available studies. Indeed, we performed a systematic review and meta-analysis of randomized-controlled trials and case-control studies, which aimed to investigate the effect of GLP1-RA or GLP1-RA/GIP on liver stiffness and steatosis evaluated with Fibroscan® (PROSPERO registration number CRD420251162316). We searched PubMed, Web of Science, and Scopus for English-language studies till March 2025. Methodological quality of the studies was assessed by the Newcastle-Ottawa Scale or Jadad score. In the presence of heterogeneity, standardized (Std) mean differences with 95% confidence intervals (CIs) were combined using a random effect model. Funnel plot and trim-and-fill analysis were used to assess publication bias. Five studies were included in the analysis, accounting for 9 trials. A total of 554 patients and 270 controls were enrolled. The analysis revealed an improvement for both liver stiffness [std. mean difference = - 0.3, 95%CI - 0.5 to - 0.1, p = 0.02] and liver steatosis [std. mean difference = - 0.4, 95%CI - 0.7 to - 0.1, p = 0.03] at the end of the trial. Our findings showed that treatment with GLP1-RA and GLP1-RA/GIP in people with MASLD improves liver stiffness and steatosis evaluated through Fibroscan®.