Tirzepatide and metabolic dysfunction-associated steatotic liver disease (MASLD) in obesity: a real-world multicenter study
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By
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Martina Galasso
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Ludovica Verde
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Renato Patrone
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Giovanni Ragozzino
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Giuseppe Annunziata
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Annamaria Colao
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Luigi Barrea
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Giovanna Muscogiuri
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July 6, 2026
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Objective:
To evaluate the effect of tirzepatide treatment in patients with obesity and MASLD and to identify the clinical predictors of its hepatic effect.
Approach:
- 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.
Key Findings:
- 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.
Interpretation:
Limitations:
- Small sample size (23 participants).
- Retrospective design may limit causal inferences.
- Exclusion of patients with other chronic liver diseases may affect generalizability.
Conclusion:
