Award: Presidential Poster Award
Soorya Aggarwal, DO1, Matthew J. Sullivan, DO1, Michal Kloska, MD1, Angela Magdaleno, DO1, Gretchen Perilli, MD1, She-Yan Wong, MD2
1Lehigh Valley Health Network, Allentown, PA; 2Eastern Pennsylvania Gastroenterology and Liver Specialists, Allentown, PA
Introduction: Non-alcoholic fatty liver disease (NAFLD) is on target to become the leading cause of cirrhosis by 2030. The GLP-1 agonist class of medications, which are highly effective weight loss agents, may result in reducing inflammation and fibrosis in NAFLD. The aim of this study was to evaluate the effects of these medications amongst NAFLD patients.
Methods: This was a single center, retrospective study of NAFLD patients who had initiated a GLP-1 agonist between January 2012 and January 2018. Patient demographics, medical co-morbidities and laboratory values were obtained from the electronic medical record. Additionally, the NAFLD fibrosis score (NFS) was calculated before and after initiation of GLP-1 agonist.
Results: In total 149 patients were studied of which 45% were male and 55% were female. 78.5% of the patients were Caucasian. 60.8% of patients were on Liraglutide and all had a diagnosis of diabetes mellitus. Prior to initiation of GLP-1 agonist, 59% of patients were in the indeterminate NFS category followed by 33.6% in F3-4 and 7.4% in F0-2. Treatment lasted on average of 29.06 months (range of 5 to 80 months). After medication use, there was a statistically significant change in patient’s BMI (p=0.018), correlating to degree of fibrosis. F3-4 patients who became intermediate stage after GLP-1 use had the largest percent change in BMI of 8.5%. In 71% of initially abnormal ALT ( >30) 17% of those patients, normalized ALT after GLP-1 agonist use. Of the 66% of patients with abnormal triglycerides ( >150), 28% normalized triglycerides after use of these medications. There was no statistically significant change in NAFLD fibrosis score after the use of GLP-1 agonist.
Discussion: In our study of fatty liver disease in diabetics, we found that over one-third of patients had severe F3-4 stage fibrosis prior to initiation of GLP-1 agonist. In this population, we showed statistically significant improvement in BMI, supporting GLP-1 agonists’ role in weight loss. Additionally, with use of GLP-1 agonist, when fibrosis stage improved, other measures of metabolic syndrome including BMI, triglycerides, and ALT also improved. Although there was no statistically significant change in NFS, this could be explained by the fact that the majority of patients had an indeterminant score prior to GLP-1 agonist use, rendering this interpretation difficult. Future investigation of histopathology with GLP-1 agonist use will help to elucidate these conclusions further.
Citation: Soorya Aggarwal, DO; Matthew J. Sullivan, DO; Michal Kloska, MD; Angela Magdaleno, DO; Gretchen Perilli, MD; She-Yan Wong, MD. P2441 - IMPACT OF GLP-1 AGONIST USE ON NON-ALCOHOLIC FATTY LIVER DISEASE AMONG PATIENTS AT A LARGE, TERTIARY CARE CENTER. Program No. P2441. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.