Rapid and substantial reversal of hepatic steatosis and fibrosis with liraglutide in a young, obese, non-diabetic male with metabolic dysfunction-associated steatotic liver disease: A case report

Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease globally. Effective pharmacological treatments that can reverse both steatosis and fibrosis are critically needed. Case Presentation: A 28-year-old male with class I obesity (BMI 33 kg/m²) presented with nonspecific abdominal symptoms. Investigations revealed elevated liver enzymes (SGPT 129 U/L, SGOT 80 U/L), and transient elastography (FibroScan) showed severe steatosis (CAP score: 362 dB/m) and significant fibrosis (LSM: 9.4 kPa). The patient was started on liraglutide in conjunction with lifestyle modification. Conclusion: At a three-month follow-up, the patient achieved a 12.9% reduction in total body weight. His liver enzymes normalized completely (SGPT 29 U/L, SGOT 24 U/L). Remarkably, repeat FibroScan demonstrated a significant reduction in steatosis (CAP score: 280 dB/m) and a regression of liver stiffness to a level indicating minimal fibrosis (LSM: 6.4 kPa). This case highlights the potent and relatively rapid efficacy of liraglutide in improving key markers of liver health in a young patient with MASLD.