Effects of Tirzepatide on Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in Obese Patients: Insights from a Multicenter Real-World Study

To evaluate the effect of tirzepatide treatment in patients with obesity and MASLD and to identify the clinical predictors of its hepatic effect.

Study Design: Retrospective study including 23 adults with overweight or obesity and MASLD, treated with tirzepatide for 3 months.
Data Collection: Assessment of anthropometric, metabolic, inflammatory, lipid, and liver enzyme parameters at baseline and follow-up.

Significant reductions in body weight, BMI, and waist circumference (all p < 0.001).
Improvements in fasting glucose, HbA1c, insulin, and HOMA-IR (all p < 0.001).
Reduction in hs-CRP indicating improved inflammatory status (p < 0.001).
Liver enzymes (AST, ALT, GGT) and lipid parameters significantly decreased (all p < 0.001) except triglycerides (p = 0.001).
FLI significantly decreased from baseline to 3 months (p < 0.001).
94FLI positively associated with 94weight, 94BMI, 94WC, 94hs-CRP, 94HbA1c, 94AST, and 94HDL cholesterol.

Small sample size (23 participants).
Retrospective design may limit causal inferences.
Exclusion of patients with other chronic liver diseases may affect generalizability.