{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T21:51:38Z","timestamp":1788299498703,"version":"build-2803163510"},"reference-count":105,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T00:00:00Z","timestamp":1779062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is strongly associated with metabolic abnormalities, shares pathophysiological pathways with metabolic syndrome, and has become a leading cause of chronic liver disease in industrialized nations. In the absence of approved pharmacological treatments and due to its high risk of progression to advanced fibrosis, MASLD represents a significant clinical challenge. Incretin-based therapies, originally developed for the treatment of type 2 diabetes mellitus and obesity, have recently gained attention as promising therapeutic strategies in hepatology. Among them, GLP-1 receptor agonists have shown efficacy in reducing hepatic steatosis, inflammation, and fibrosis-related biomarkers, primarily through weight loss and enhanced insulin sensitivity. Dual agonists targeting both GLP-1 and GIP receptors, such as tirzepatide, have demonstrated superior outcomes in improving hepatic and metabolic parameters. Emerging agents like cotadutide (a GLP-1\/glucagon receptor agonist) and retatrutide (a GLP-1\/GIP\/glucagon triagonist) represent a novel therapeutic frontier, with early clinical data indicating potent hepatoprotective effects and favorable metabolic remodeling. This narrative review examines the hepatoprotective potential of incretin-based therapies, highlighting how targeted intervention on the underlying metabolic dysfunction may lead to significant improvements in MASLD. These therapies may also exert beneficial effects on fibrosis progression; however, the currently available evidence remains limited.<\/jats:p>","DOI":"10.3390\/medicina62050986","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T10:19:52Z","timestamp":1779877192000},"page":"986","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Metabolic Dysfunction-Associated Steatotic Liver Disease and Incretin Receptor Agonists: A Metabolic Approach to Halting Liver Disease Progression"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5922-1524","authenticated-orcid":false,"given":"Ludovico","family":"Abenavoli","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"},{"name":"Center for Chronic Liver Diseases, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8224-7407","authenticated-orcid":false,"given":"Anna Giulia","family":"Loricchio","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"},{"name":"Center for Chronic Liver Diseases, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"},{"name":"Center for Chronic Liver Diseases, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Morano","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"},{"name":"Center for Chronic Liver Diseases, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7435-271X","authenticated-orcid":false,"given":"Abdulrahman","family":"Ismaiel","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Lucian","family":"Dumitrascu","sequence":"additional","affiliation":[{"name":"2nd Department of Internal Medicine, \u201cIuliu Hatieganu\u201d University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5120-1046","authenticated-orcid":false,"given":"Francesco","family":"Luzza","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of Catanzaro \u201cMagna Graecia\u201d, 88100 Catanzaro, Italy"},{"name":"Center for Chronic Liver Diseases, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"key":"ref_1","unstructured":"European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), and European Association for the Study of Obesity (EASO) (2024). 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