Effect of semaglutide on fatty liver disease biomarkers in patients with diabetes and obesity

Aim: This work aims to assess the effect of weekly subcutaneous semaglutide on biomarkers of metabolic-associated fatty liver disease (MAFLD), namely the hepatic steatosis index (HSI) and the fibrosis-4 (FIB-4) index, at 24 weeks in outpatients attended to in internal medicine departments.Methods: This study analyzed patients in an ongoing, multicenter, prospective, pre-post, uncon-trolled cohort registry that enrolls unique, consecutive patients with type 2 diabetes treated with weekly subcutaneous semaglutide. Steatosis/fibrosis were determined by HSI (< 30 ruled out, > 36 steatosis) and FIB-4 (< 1.3 ruled out, > 2.67 fibrosis), respectively.Results: The sample included 213 patients (46.9% women) with a median age of 64 (& PLUSMN; 19) years. The median baseline body mass index and weight were 36.1 (& PLUSMN; 8.4) kg/m2 and 98 (& PLUSMN; 26.9) kg, respectively. A total of 99.9% had HSI values indicating steatosis, with a mean HSI of 47.9 (& PLUSMN; 8.2). Additionally, 10.8% had fibrosis (FIB-4 > 2.67) and 42.72% had values in intermediate ranges (FIB-4 1.3-2.67). At 24 weeks, there was a significant reduction in HSI (-2.36 (95% CI: 1.83-2.9), p < 0.00001) and FIB-4 (-0.075 (95% CI: 0.015-0.14), p < 0.016), mainly related to declines in body weight, triglyceride levels, insulin resistance (estimated by the triglyceride-glucose index), and liver enzymes.Conclusion: These results show that weekly subcutaneous semaglutide had a beneficial effect on liver steatosis that went beyond glucose control. Its effects were mainly related to weight loss, a decline in biomarkers, and improvements in insulin sensitivity. For many patients, early detection is essential for improving MAFLD outcomes and may allow for selecting the most efficient treatment options.& COPY; 2022 Published by Elsevier Espana, S.L.U.