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Beyond glucose lowering and weight reduction, GLP-1based therapies exert multiple mechanistic effects that directly target the pathophysiology of MASLD/MASH: Reduction of hepatic de novo lipogenesis Improvement in insulin sensitivity Suppression of hepatic glucose production Reduction in visceral and ectopic fat accumulation Enhancement of mitochondrial function and fatty acid oxidation Anti-inflammatory signaling with decreased cytokine activation Potential attenuation of hepatocellular injury and fibrosis progression Importantly, the benefits of GLP-1 therapies appear to extend beyond simple weight loss alone

The primary mechanisms of action include: Enhancing glucose-dependent insulin secretion from pancreatic beta cells, which helps lower blood glucose levels when they are elevated Suppressing glucagon release from pancreatic alpha cells, reducing hepatic glucose production [1] [2] Slowing gastric emptying , which moderates the rate at which nutrients enter the bloodstream Promoting satiety through central nervous system pathways, leading to reduced caloric intake [1] [2] These medications are peptide-based (and one fusion protein) and are temperature sensitive

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[DOI] [PubMed] [Google Scholar] 153.Fox C.K., Marlatt K.L., Rudser K.D., Kelly A.S

Federal rules bar manufacturer copay cards from government-funded prescriptions, so Medicare and Medicaid patients cannot use it