Lifestyle and Pharmacological Interventions for Metabolic Dysfunction-Associated Fatty Liver Disease: A Systematic Review
Year: 2025
Type: review
Study design: Systematic Review
Abstract: Background & aim: Metabolic Dysfunction-Associated Fatty Liver Disease, a common condition linked to the global epidemics of obesity and type 2 diabetes, is a major health concern. The condition can progress from simple steatosis to metabolic dysfunction-associated steatohepatitis (MASH), cirrhosis, and hepatocellular carcinoma. Currently, there is no universal cure and disease prevention strategies are the primary focus. The main treatment approaches are lifestyle changes and pharmacological interventions. The aim of the study was to compare these two strategies, assessing their mechanisms, efficacy, safety and clinical utility. Methods: The systematic review was conducted by combining and evaluating data from range of peer-reviewed scientific publications, including clinical trials, systematic reviews and meta-analyses, comprising a total of 10 studies and 1987 patients. The data was categorized using two primary treatment modalities: Lifestyle changes (interventions like weight loss, specific dietary patterns and physical activity) and pharmacological interventions (Pioglitazone, Liraglutide (GLP1 agonist) and Vitamin E). Each approach was evaluated for its ability to improve liver histology, reduce liver fat and resolve MASH. Results & Conclusion: Lifestyle interventions, particularly structured dietary modifications and regular physical activity, consistently demonstrated significant reductions in hepatic steatosis, improvement in insulin sensitivity, and, in some cases, regression of fibrosis. Pharmacological agents such as pioglitazone, vitamin E, and GLP-1 receptor agonists provided histological and metabolic benefits, with pioglitazone improving fibrosis, vitamin E reducing oxidative stress and inflammation, and GLP-1 agonists contributing to weight loss and metabolic improvement. While pharmacological agents offer targeted benefits, lifestyle interventions proved more sustainable and broadly effective across populations.
Source: JUNIOR RESEARCHERS
Authors: Tatia Khachidze, Gela Sulaberidze, Gocha Barbakadze, Sandro Mushkudiani
Institution: Tbilisi State Medical University
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4416967166