Glucagon-like peptide-1 (GLP-1)-based
therapies have demonstrated efficacy and safety in treating
type 2 diabetes, which shares a similar pathophysiological mechanism with
non-alcoholic fatty liver disease (
NAFLD). Recent studies showed that
glucose-induced
GLP-1 secretion was decreased in patients with
NAFLD and that the level of dipeptidyl peptidase-4, which inactivates intact
GLP-1, was upregulated. Moreover, the expression of the
GLP-1 receptor was downregulated in livers from patients with
NAFLD, indicating an association of defective
GLP-1 signalling with
NAFLD. Notably, GLP-1-based
therapies are reported to be effective in improving hepatic endpoints in patients with
NAFLD, such as reducing hepatic fat content, hepatic steatosis and plasma
transaminase levels, and preventing
fibrosis. GLP-1-based
therapies are beneficial for
body weight control and glycaemic normalisation, which are important for the management of
NAFLD. Moreover, clinical and preclinical studies showed that GLP-1-based agents might directly exert their actions on the liver through activation of functional
GLP-1 receptors in hepatocytes. The possible mechanisms involve regulating gene expression that is associated with
insulin resistance and lipid metabolism, and suppressing oxidative stress in the liver cells, thus preventing the development and progression of
NAFLD. Based on these promising data, large-scale randomised controlled trials are warranted to assess the efficacy and safety of GLP-1-based
therapies in treating
NAFLD.