Glucagon-like Peptide-1 Receptor Agonists—A Potential New Medication for Pediatric Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD)

• Type of Material: Article
• Authors: Erika Choi, Emory University; Ana Maria Ramirez Tovar, Emory University; Zhulin He, Emory University; Dellys M. Soler Rodriguez, Emory University; Miriam Benedicta Vos, Emory University; Shruthi Arora, Emory University; Doris Fadoju, Emory University
• Language: English
• Date: 2024-03
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2024 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.3390%2Fchildren11030275
• Title of Journal or Parent Work: Children
• Volume: 11
• Issue: 3
• Start Page: 275
• Grant/Funding Information: Supported by the National Institutes of Health (NIH), grant numbers R01NRigure and R01DK125701.
• Keywords: MASLD; liver steatosis; obesity; ALT; GLP-1
• Research Categories: Health Sciences, Public Health; Biology, Cell

Abstract

Metabolic-dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease in children in the US and, if untreated, may progress to end-stage liver disease. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown improvement in MASLD markers in adults with type 2 diabetes mellitus (T2DM). Currently, there is a lack of medications available for the treatment of pediatric MASLD. We aimed to provide preliminary data on the effects of GLP-1 RAs on markers of MASLD in a retrospective study, in an effort to bridge this gap in the pharmacotherapies available. Nine patients from a T2DM clinic who met the following inclusion criteria were included in this study: patients diagnosed with pre-diabetes or T2DM, prescribed a GLP-1 RA in the prior 12 months, and having alanine aminotransferase (ALT) elevated to twice the upper limit of the normal range, indicating evidence of MASLD. The average change between baseline and the first measurement after starting a GLP-1 RA was calculated for ALT, hemoglobin A1c, and BMI. ALT decreased by an average of 98 points. A1c decreased by an average of 2.2 points. BMI decreased by an average of 2.4 points. There was greater reduction in ALT and A1c compared to BMI, suggesting that improvement in MASLD may be independent of weight loss. This is a preliminary study that shows potential, and prospective studies are needed to evaluate the effects of GLP-1 RAs in the management of pediatric MASLD.