Research Progress of GLP-1 Receptor Agonists in the Treatment of Metabolic Dysfunction-Associated Steatotic Liver Disease

代谢功能障碍相关脂肪性肝病(MASLD)是一种与多种代谢异常密切相关的慢性肝脏疾病，其核心病理特征为脂肪在肝细胞内异常堆积，且排除其他已知致病因素，如酒精性肝病、病毒性肝炎及自身免疫性疾病等。MASLD与代谢综合征和2型糖尿病之间相互影响，共同促进动脉粥样硬化性心脏病、慢性肾脏病及肝细胞癌等恶性肿瘤等多种并发症的发生。这种复杂的代谢网络使得MASLD成为日益严峻的公共卫生问题。2024年，瑞美替罗成为首个获美国食品药品监督管理局批准用于治疗MASH的药物，然而针对MASLD的早期阶段仍缺乏获批药物。在此背景下，胰高血糖素样肽-1 (GLP-1)受体激动剂因其独特的多靶点调控作用，在MASLD治疗中展现出显著的临床应用潜力。本研究旨在系统分析GLP-1受体激动剂在MASLD治疗中的作用机制，并结合循证医学证据评估其疗效与安全性，为临床实践提供理论依据。Metabolic dysfunction-associated fatty liver disease (MASLD) is a chronic liver disease closely related to a variety of metabolic abnormalities, and its core pathological feature is abnormal accumulation of fat in hepatocytes, and other known pathogenic factors, such as alcoholic liver disease, viral hepatitis and autoimmune diseases, are excluded. MASLD interacts with metabolic syndrome and type 2 diabetes mellitus, and jointly promotes the occurrence of various complications such as atherosclerotic heart disease, chronic kidney disease, and hepatocellular carcinoma. This complex metabolic network makes MASLD a growing public health problem. In 2024, remettirol became the first drug approved by the U.S. Food and Drug Administration for the treatment of MASH, although there is still a lack of approved drugs for MASLD in the early stages. In this context, glucagon-like peptide-1 (GLP-1) receptor agonists have shown significant clinical application potential in the treatment of MASLD due to their unique multi-target regulatory effects. The purpose of this study was to systematically analyze the mechanism of action of GLP-1 receptor agonists in the treatment of MASLD, and to evaluate their efficacy and safety based on evidence-based medical evidence, so as to provide a theoretical basis for clinical practice.