{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T06:14:58Z","timestamp":1783318498772,"version":"3.54.6"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T00:00:00Z","timestamp":1783296000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide and is strongly associated with obesity, insulin resistance, and systemic inflammation. Tirzepatide, a dual GIP and GLP-1 receptor agonist, has shown significant effects on weight loss and metabolic control. However, real-world evidence on hepatic steatosis remains limited. The aim of this study was to evaluate the effect of tirzepatide treatment in patients with obesity and MASLD and to identify the clinical predictors of its hepatic effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, 23 adults with overweight (BMI \u226527.0 kg\/m\u00b2) with at least one weight-related comorbidity and patients with obesity (BMI \u226530.0 kg\/m\u00b2) and MASLD (FLI &amp;gt; 44) were included. Participants received tirzepatide (2.5\u20135 mg weekly) for 3 months. Anthropometric, metabolic (glucose, insulin, HOMA-IR, HbA1c), lipid (cholesterol, HDL, LDL, triglycerides), inflammatory (hs-CRP), and liver enzyme (AST, ALT, GGT) parameters, together with FLI, were assessed at baseline and follow-up. Correlations of \u0394FLI with clinical variables and multiple regression analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After three months of treatment, significant reductions were observed in body weight, BMI, and waist circumference (all p &amp;lt; 0.001). Significant improvements were also found in fasting glucose (p = 0.001), HbA1c, insulin, and HOMA-IR (all p &amp;lt; 0.001). Inflammatory status improved, with a significant reduction in hs-CRP (p &amp;lt; 0.001). Liver enzymes (AST, ALT, GGT) and lipid parameters significantly decreased (all p &amp;lt; 0.001) except triglycerides (p = 0.001). FLI significantly decreased from baseline to 3 months (p &amp;lt; 0.001). Correlation analyses showed that \u0394FLI was positively associated with \u0394weight (p &amp;lt; 0.001), \u0394BMI (p &amp;lt; 0.001), \u0394WC (p = 0.002), \u0394hs-CRP (p = 0.007), \u0394HbA1c (p = 0.045), \u0394AST (p = 0.026), and \u0394HDL cholesterol (p = 0.023). Multiple regression analysis identified \u0394hs-CRP as the only independent predictor of \u0394FLI (p = 0.007), explaining 29.8% of the variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In a real-world setting, tirzepatide was associated with significant improvements in MASLD along with metabolic parameters and inflammation in obesity. Improvement in MASLD was independently associated with reduced low-grade inflammation. These findings support tirzepatide as a potential therapeutic option for MASLD management in the context of obesity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1855886","type":"journal-article","created":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T05:36:34Z","timestamp":1783316194000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tirzepatide and metabolic dysfunction-associated steatotic liver disease (MASLD) in obesity: a real-world multicenter study"],"prefix":"10.3389","volume":"17","author":[{"given":"Martina","family":"Galasso","sequence":"first","affiliation":[{"name":"Centro Italiano per la cura e il Benessere del Paziente con Obesit\u00e0 (C.I.B.O), Unit\u00e0 di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Universit\u00e0 degli Studi di Napoli Federico II","place":["Naples, Italy"]},{"name":"Department for the Promotion of Human Sciences and Quality of Life, San Raffaele Roma Open University","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludovica","family":"Verde","sequence":"additional","affiliation":[{"name":"Centro Italiano per la cura e il Benessere del Paziente con Obesit\u00e0 (C.I.B.O), Unit\u00e0 di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Universit\u00e0 degli Studi di Napoli Federico II","place":["Naples, Italy"]},{"name":"Division of Endocrinology, Department of Medicine, The University of Arizona College of Medicine","place":["Tucson, AZ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato","family":"Patrone","sequence":"additional","affiliation":[{"name":"Unit of Abdominal Oncology, Division of Hepatobiliary Surgical Oncology, Istituto Nazionale Tumori,Fondazione G. Pascale, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS)","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Ragozzino","sequence":"additional","affiliation":[{"name":"Ambulatorio di Endocrinologia, Diabetologia e Nutrizione Clinica, Dipartimento di Scienze e Tecnologie Ambientali, Biologiche e Farmaceutiche (DiSTABiF), Universit\u00e0 degli studi della Campania","place":["Caserta, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Annunziata","sequence":"additional","affiliation":[{"name":"Department for the Promotion of Human Sciences and Quality of Life, San Raffaele Roma Open University","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Colao","sequence":"additional","affiliation":[{"name":"Centro Italiano per la cura e il Benessere del Paziente con Obesit\u00e0 (C.I.B.O), Unit\u00e0 di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Universit\u00e0 degli Studi di Napoli Federico II","place":["Naples, Italy"]},{"name":"Dipartimento di Medicina Clinica e Chirurgia, Unit\u00e0 di Endocrinologia, Diabetologia ed Andrologia,Universit\u00e0 degli Studi di Napoli Federico II","place":["Naples, Italy"]},{"name":"Cattedra Unesco \u201cEducazione Alla Salute E Allo Sviluppo Sostenibile\u201d, Universit\u00e0 degli Studi di Napoli Federico II","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Barrea","sequence":"additional","affiliation":[{"name":"Dipartimento di Psicologia e Scienze della Salute, Universit\u00e0 Telematica Pegaso, Via Porzio","place":["Naples, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Muscogiuri","sequence":"additional","affiliation":[{"name":"Centro Italiano per la cura e il Benessere del Paziente con Obesit\u00e0 (C.I.B.O), 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