Oral Semaglutide Improves liver steatosis and injury in Diabetes Patients with MASLD, suggests study

A recent study highlights the potential benefits of oral semaglutide in managing type 2 diabetes mellitus (T2DM) for patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This single-arm, multicenter, prospective trial showed oral semaglutide to improve glycemic control, reduce body weight, and enhance liver health in patients with both T2DM and MASLD. The findings published in the Diabetes, Obesity and Metabolism journal are expected to contribute to treatment strategies for managing complex cases of diabetes where liver health is also compromised.

The study spanned for 48 weeks and included 80 patients initially, with 70 completing the trial. These patients had newly initiated oral semaglutide therapy and were monitored across several parameters, including body weight, liver enzymes, lipid profile, glycemic control, and liver fibrosis markers. Dose adjustments were tailored to response of every patient and the presence of any adverse reactions, managed under close supervision by their physicians.

The results demonstrated significant improvements across multiple health markers. The patients showed notable reductions in body weight, liver enzyme levels, and controlled attenuation parameter (CAP) values, all reflecting a positive shift in liver health when compared to baseline readings. CAP values were significantly lower which indicated reduced liver steatosis. Alanine aminotransferase (ALT) levels which is associated with liver damage, also saw significant reductions which highlighted the potential of the medication in managing liver-related issues among diabetic patients.

In addition to these findings, improvements in the lipid profile were evident. The patients displayed better levels of cholesterol and triglycerides, essential for reducing the risk of cardiovascular complications in diabetes. The study also tracked markers for liver fibrosis like type IV collagen 7S, Wisteria floribunda agglutinin-positive Mac-2-binding protein, the fibrosis-4 index, and liver stiffness measurement. All showed a decrease from baseline by indicating that oral semaglutide might aid in slowing down or potentially reversing the fibrotic process in the liver.

The positive effects on liver enzymes and CAP values were significantly correlated with weight loss which meant that as patients lost weight, their liver health markers also improved. This connection highlighted the importance of weight management in patients with T2DM and MASLD. About 28.8% of patients experienced nausea, 15% had dyspepsia, and 5% reported a loss of appetite. These symptoms were transient and categorized as mild to moderate, with no serious side effects reported. Overall, the study highlighted the potential of oral semaglutide as a therapeutic option not only for managing blood sugar levels but also for addressing liver health in diabetic patients with MASLD. 

Source:

Arai, T., Atsukawa, M., Tsubota, A., Oikawa, T., Tada, T., Matsuura, K., Ishikawa, T., Abe, H., Kato, K., Morishita, A., Tani, J., Okubo, T., Nagao, M., Iwabu, M., & Iwakiri, K. (2024). Beneficial effect of oral semaglutide for type 2 diabetes mellitus in patients with metabolic dysfunction‐associated steatotic liver disease: A prospective, multicentre, observational study. In Diabetes, Obesity and Metabolism (Vol. 26, Issue 11, pp. 4958–4965). Wiley. https://doi.org/10.1111/dom.15898