Clin Mol Hepatol > Accepted Articles
Comparison of glucagon-like peptide-1 receptor agonists and thiazolidinediones on treating nonalcoholic fatty liver disease: A network meta-analysis
Min Jeong Park1, Hayeon Kim2, Myeong Gyu Kim3, Kyungim Kim2,4
1Division of Endocrinology & Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea
2College of Pharmacy, Korea University, Sejong, Republic of Korea
3College of Pharmacy, Ewha Womans University, Seoul, Republic of Korea
4Institute of Pharmaceutical Science, Korea University, Sejong, Republic of Korea
Correspondence :  Kyungim Kim ,
Tel: +82-44-860-1624, Fax: +82-44-860-1606, Email:
Received: October 22, 2022  Revised: January 25, 2023   Accepted: March 6, 2023
*Min Jeong Park and Hayeon Kim contributed equally to this work.
Previous studies have revealed that glucagon-like peptide-1 receptor agonist (GLP-1RA) and thiazolidinedione (TZD) can improve nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steatohepatitis (NASH). However, comprehensive research comparing the effects of GLP-1RA and TZD is limited. Thus, this study aimed to compare the effects of GLP-1RA and TZD on NAFLD or NASH through a network meta-analysis.
The PubMed, Embase, Web of Science, and Scopus databases were searched for randomized controlled trials (RCTs) that explored the efficacy of GLP-1RAs or TZDs in adult patients with NAFLD or NASH. The outcomes were liver biopsy-based (NAFLD activity score [NAS], fibrosis stage, and NASH resolution), noninvasive technique-based (liver fat content on proton magnetic resonance spectroscopy [1H-MRS] and controlled attenuation parameter [CAP]), biological, and anthropometric indicators. A random effects model was used to calculate the mean difference (MD) and relative risk with 95% confidence interval (CI).
Twenty-five RCTs with 2,237 overweight or obese patients were included. GLP-1RA was significantly superior in reducing liver fat content evaluated using 1H-MRS (MD –2.42, 95% CI –3.84 to –1.00), body mass index (MD –1.60, 95% CI –2.41 to –0.80), and waist circumference (MD –4.89, 95% CI –8.17 to –1.61) than TZD. In liver biopsy-based evaluation and liver fat content assessment using CAP, GLP-1RA tended to surpass TZD, albeit not significantly. Sensitivity analysis showed consistent results with the main results.
Compared with TZD, GLP-1RA had better effects on liver fat content, body mass index, and waist circumference in overweight or obese patients with NAFLD or NASH.
KeyWords: Glucagon-like peptide-1 receptor agonist; Thiazolidinedione; Nonalcoholic steatohepatitis; Nonalcoholic fatty liver disease; Network meta-analysis

Editorial Office
The Korean Association for the Study of the Liver
Room A1210, 53 Mapo-daero(MapoTrapalace, Dowha-dong), Mapo-gu, Seoul, 04158, Korea
TEL: +82-2-703-0051   FAX: +82-2-703-0071    E-mail:
Copyright © The Korean Association for the Study of the Liver.         
TODAY : 1229
TOTAL : 1298441
Close layer