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Pharmacol Res. 2018 Nov;137:219-229. doi: 10.1016/j.phrs.2018.09.025. Epub 2018 Oct 22.

Multiple target tissue effects of GLP-1 analogues on non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH).

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Laboratory of Cell Metabolism and Regenerative Medicine, Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy.
Department of Internal Medicine ASST Santi Paolo e Carlo, Milan, Italy.
Laboratory of Clinical Biochemistry and Mass Spectrometry, Department of Health Science, University of Milan, Milan, Italy.
Metabolic Disease and Diabetes, Humanitas Research Hospital, Rozzano, Milan, Italy.
Unit of Medicine, Gastroenterology and Hepatology, Milan, Italy.
Unit of Endocrinology and Metabolism ASST Santi Paolo e Carlo, Department of Health Science, University of Milan, Milan, Italy. Electronic address:


Accumulating experimental and clinical evidences over the last decade indicate that GLP-1 analogues have a series of central nervous system and peripheral target tissues actions which are able to significantly influence the liver metabolism. GLP-1 analogues pleiotropic effects proved to be efficacious in T2DM subjects not only reducing liver steatosis and ameliorating NAFLD and NASH, but also in lowering plasma glucose and liver inflammation, improving cardiac function and protecting from kidney dysfunction. While the experimental and clinical data are robust, the precise mechanisms of action potentially involved in these protective multi-target effects need further investigation. Here we present a systematic review of the most recent literature data on the multi-target effects of GLP-1 analogues on the liver, on adipose and muscular tissue and on the nervous system, all capable of influencing significant aspects of the fatty liver disease physiopathology. From this analysis, we can conclude that the multi-target beneficial action of the GLP-1 analogues could explain the positive effects observed in animal and human models on progression of NAFLD to NASH.


GLP-1 analogues; Insulin resistance; Liver inflammation; Liver steatosis; Non-alcoholic fatty liver disease – NAFLD; Non-alcoholic steato-hepatitis NASH; Type 2 diabetes

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