Latest news with #MAFLD
Time of India
01-07-2025
- Health
- Time of India
Fatty liver: Doctor suggests 5 simple exercises to check if you are fit
Fatty liver is more than just a liver problem—it's a big red flag for your overall heart and metabolic health. You may think it's harmless fat sitting quietly in your liver, but it's not. Non-alcoholic fatty liver disease (NAFLD), which is now being renamed to metabolic-associated fatty liver disease (MAFLD), is strongly linked to issues like high blood pressure, type 2 diabetes, obesity, and heart disease. When fat builds up in your liver, it messes with how your body handles insulin and sugar, which can increase inflammation and raise your risk for strokes and heart attacks. The scary part? You may not even feel symptoms until it's too late. Recently, Cyriac Abby Philips, popularly known as TheLiverDoc, posted about fatty liver, how it is related to cardiometabolic health and simple tests to know if one is healthy and fit or not. "The best treatment for fatty liver disease is to prevent it by improving your cardiometabolic health. Here is a small list of tasks that I advise my patients to undergo to assess their "fitness" before I prescribe exercise for treating fatty liver," he has posted on X. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like Switch to UnionBank Rewards Card UnionBank Credit Card Apply Now Undo He recommends the following exercises: The One-Minute Sit-to-Stand Test The One-Minute Sit-to-Stand Test (1-MSTS) is a quick and simple way to assess lower body strength and functional capacity. To perform it, sit on a sturdy chair about 45 cm high with your arms crossed over your chest. On the signal 'go,' stand up fully and sit back down repeatedly for 60 seconds—without using your hands. Count how many full stands you complete. For adults aged 45–59, fewer than 14 stands indicates low functional capacity, while more than 20 stands is considered a good result. It's a powerful home test to check mobility, endurance, and overall leg strength. The Three-Minute Step Test The Three-Minute Step Test is a simple way to evaluate cardiovascular fitness and recovery. Using a 12-inch (30 cm) step or stair, step up and down in a rhythmic pattern—up-up, down-down—for 3 minutes at a pace of 24 steps per minute. Immediately after, sit down, locate your pulse, and count your heartbeats from 30 to 60 seconds after exercise. For individuals aged 40–49, a recovery pulse over 96 beats per minute may indicate reduced physical fitness and strength due to inactivity. A recovery pulse at or below 80 bpm is considered a good sign of cardiovascular health. The Forearm Plank Hold The Forearm Plank Hold is a simple yet effective test of core strength and muscular endurance. To perform it, lie face down on the floor with elbows directly under your shoulders. Lift your body so it forms a straight line from ears to heels, engaging your core and keeping hips level—no sagging or lifting. Hold the position as long as you can. For adults aged 40–59, holding less than 30 seconds may indicate poor fitness, while holding between 90 to 120 seconds reflects very good endurance. This test helps gauge core stability, a key element in overall functional fitness. The Wall-Sit Test The Wall-Sit Test, also known as the Isometric Squat Test, evaluates lower-body strength and endurance. To perform it, stand with your back against a wall, feet shoulder-width apart and about 60 cm forward. Slide down until your knees form a 90° angle, keeping your back flat against the wall and arms crossed. Hold this position as long as possible without breaking form. For adults aged 40–59, holding for less than 30 seconds indicates poor lower-body fitness, while holding for more than 75 seconds reflects strong endurance. This test helps assess leg strength crucial for mobility and injury prevention. The Modified Push-Up to Fatigue test The Modified Push-Up to Fatigue test evaluates upper body and core strength, particularly for adults aged 40–59. To perform it, start on your knees with hands slightly wider than shoulder-width apart. Lower your body until your chest nearly touches the floor, then push back up, keeping a straight line from head to knees. Repeat continuously until you can no longer maintain proper form. Completing fewer than 10–12 reps suggests low strength, while more than 25 is considered above average. This test is a simple yet effective way to measure muscular endurance and assess functional fitness in middle age. He also suggests to first, stop immediately and seek medical attention if you experience dizziness, chest pain, or unusual shortness of breath during any activity. These quick tests are not a substitute for a professional, graded lab test, but they can reveal weak links in your everyday physical ability. If you fail more than one of these simple benchmarks, it's a clear sign that you need to prioritize regular physical activity. Investing in movement today may significantly impact your long-term health, quality of life, and longevity. It's never too late to start taking care, he says. Get the latest lifestyle updates on Times of India, along with Doctor's Day 2025 , messages and quotes!
Medscape
30-05-2025
- Health
- Medscape
Liver Disease Common in Kids and Teens With Severe Obesity
Metabolic-associated fatty liver disease (MAFLD) was more prevalent in children and adolescents with severe obesity, with these patients showing more pronounced insulin resistance and a higher number of metabolic syndrome (MetS) components. METHODOLOGY: Researchers evaluated the prevalence of MAFLD in 212 children and adolescents with severe obesity (mean age, 13.2 years; 53.8% girls) recruited from four medical centres in Poland from May 2022 to September 2023. Severe obesity was defined as having a body mass index (BMI) > 30 for individuals aged 3-6 years, > 35 for individuals aged 6-14 years, and > 40 for individuals older than 14 years. All patients underwent abdominal ultrasonography, physical examination, body composition analysis, and biochemical assessment. MAFLD was diagnosed on the basis of liver steatosis detected by ultrasonography and/or persistently elevated alanine aminotransferase concentrations (> 52 U/L for boys and > 44 U/L for girls). MetS was confirmed using the International Diabetes Federation (IDF) criteria for children aged 10 years or older and modified IDF criteria for those younger than 10 years. The association of hepatosteatosis with anthropometric profiles and metabolic risk factors was also assessed. TAKEAWAY: MAFLD was present in 59.0% of patients, with sonographic assessment of hepatosteatosis in 55.4% of patients and elevated alanine aminotransferase concentrations without liver steatosis in 3.3% of patients. MetS was diagnosed in 66.5% of patients with MAFLD vs 57.5% of patients without MAFLD, with a significantly higher proportion of patients with MAFLD having four or more MetS components (33.6% vs 12.6%; P = .0004). = .0004). Patients with MAFLD had higher glucose and insulin levels both at fasting and 120 minutes during the oral glucose tolerance test. Increased insulin resistance was noted more frequently in patients with MAFLD than in those without MAFLD (16.5% vs 6.5%; P = .04). = .04). A ratio of alanine aminotransferase to aspartate aminotransferase > 1.5 (adjusted odds ratio [aOR], 19.79; P = .018) and a fasting glucose level > 100 mg/dL (aOR, 44.53; P = .009) were independently associated with MAFLD. IN PRACTICE: "MAFLD is a predictor of developing MetS and an increased risk of its components, especially glucose metabolism disorders. Therefore, patients diagnosed with MAFLD should be under special medical supervision for the detection and prevention of metabolic complications," the authors wrote. SOURCE: This study was led by Magdalena Mierzwa, Medical University of Silesia, Zabrze, Poland. It was published online on May 20, 2025, in the Journal of Clinical Medicine . LIMITATIONS: Ultrasound-based steatosis assessments varied by centre, potentially leading to discrepancies due to subjective assessment. This cross-sectional study involved only children and adolescents with severe obesity, thereby limiting generalizability. DISCLOSURES: This study was supported by the National Science Center, Poland. One author reported being employed by Mediagnost GmbH.
The Hindu
27-05-2025
- Health
- The Hindu
India's new urban worry — rising overnutrition
A recent article in Nature that studied the prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) among IT employees in Hyderabad had alarming findings: 84% of the participants had fatty liver, indicating MAFLD, and 71% were obese. This striking statistic underscores a larger, more insidious public health crisis that is emerging in tandem with the growth of India's urban economy. The underlying drivers are chronic stress, excess salt intake, disrupted sleep patterns, and prolonged sedentary routines, particularly among those in the technology sector. IT companies often tether employees to their desks by offering free kiosks stocked with snacks that fall short of nutritional standards. Urban India's crisis India is grappling with a paradoxical nutritional landscape. While undernutrition remains a concern in many regions, overnutrition is now rapidly escalating in urban centres. In 2021, India ranked second globally in overweight and obesity prevalence. The trend is particularly evident in metropolitan IT corridors, where professionals are unwittingly becoming the face of a silent metabolic crisis. India's double burden of malnutrition — rampant undernutrition coexisting with overnutrition — is reflected in its low ranking on the Global Hunger Index. According to the World Health Organization (WHO), noncommunicable diseases (NCDs) were responsible for 74% of global deaths in 2019 (it was 61% in 2000). These diseases disproportionately affect low- and middle-income countries, including India. WHO's 2024 World Health Statistics warns that NCDs and obesity are increasingly prevalent in the most economically productive segment of society. Without substantial policy interventions, regions such as South-East Asia are unlikely to meet the 2030 Sustainable Development Goal (SDG) targets to reduce premature mortality from NCDs. In Tamil Nadu, the 2023-24 STEPS Survey paints a stark picture: over 65% of deaths in Chennai are attributable to NCDs. While the NCD cascade of care has shown improvement, there are significant gaps. Among those receiving treatment for hypertension, only 16% have achieved blood pressure control, and for individuals aged 18-44, this drops to just 9.3%. Among diabetics in the same age group, only 9.8% manage to maintain glycaemic control. The prevalence of overweight and obesity stands at 31.6% and 14.2%, respectively. Additionally, 94.2% of respondents reported inadequate fruit and vegetable consumption, while 24.4% reported insufficient physical activity. Tamil Nadu's Makkalai Thedi Maruthuvam (MTM) programme, deserves mention for its multisectoral approach to NCD control. From January 2024, 3,79,635 employees have been screened through workplace interventions. The eight-kilometre health walk and the 'Eat Right Challenge' were introduced to encourage behavioural change and nutrition awareness. However, the unchecked growth of fast food outlets in metros remains a formidable obstacle. The National Family Health Survey-5 shows that obesity steadily rises with age, from 7% among men (15-19 years) to 32% among those aged 40 to 49 years. The prevalence of overweight or obesity rises from 10% in the lowest wealth quintile to 37% in the highest wealth quintile. The widespread prevalence of overweight and obesity across age groups and income levels underscores that this is not an isolated occupational hazard, but a population-wide health crisis in the making. These trends align closely with data for women. Waist-to-hip ratio (WHR), another NCD risk marker, also increases with age: 46% to 65% in women and 28% to 60% in men (ages 15 to 49). In Tamil Nadu, urban areas report a higher NCD prevalence when compared to rural areas. Overweight or obesity affects 46.1% of urban men and 43.1% of urban women, compared to 35.4% and 31.6%, respectively, in rural areas. The 18 to 59 age bracket which contributes to Tamil Nadu's majority working force is most vulnerable to early-onset NCDs, also compounded by a growing dependence on ultra-processed foods, alongside other established factors. A Lancet article (2025) estimates that India's overweight and obese adult population could touch 450 million by 2050 (180 million in 2021). Simultaneously, childhood obesity has surged by 244% over the past three decades and is expected to climb another 121% in the next three. Focus on manufacturing and marketing While nutrition awareness at the consumer level is growing, it remains insufficient. The greater responsibility lies with regulators, producers, and policymakers. The market is saturated with ultra-processed foods that offer convenience but little in the way of nourishment. Consumers are frequently left choosing from options that are inherently unhealthy. To address this, the Eat Right India movement, led by the Food Safety and Standards Authority of India (FSSAI), promotes safe, healthy, and sustainable food. It includes hygiene ratings, certification programmes, and campaigns such as 'Aaj Se Thoda Kam,' which encourages consumers to gradually reduce their intake of fat, sugar, and salt. In partnership with the Indian Council of Medical Research and the National Institute of Nutrition, the FSSAI advocates labelling high-fat, salt, and sugar (HFSS) foods, empowering consumers to make informed choices. In 2022, the FSSAI proposed the Health Star Rating (HSR) aimed at clearer nutritional information on packaged foods. However, the HSR system has sparked debate among medical practitioners and nutrition experts, on its effectiveness. The Supreme Court of India recently directed an FSSAI-constituted expert committee to submit scientific and technical advice on food safety matters, which includes recommendations on food labelling norms. However, these efforts must be backed by stricter enforcement and broader multisectoral coordination. Nutritional regulation must extend beyond messaging campaigns to influence what is manufactured, marketed and made available. The Saudi Arabian model Saudi Arabia offers a compelling model. As part of its Vision 2030 initiative, the kingdom has embedded NCD prevention into its national policy framework. It enforces calorie labelling in restaurants, imposes a 50% excise tax on sugar-sweetened beverages, and levies a 100% tax on energy drinks. It has instituted sodium limits in processed foods. Saudi Arabia is among the few nations meeting WHO's sodium reduction best practices and recognised for eliminating trans fats. Its success lies in the coherence of its strategy — integrating health, regulatory oversight, industry compliance, and civic engagement. Meanwhile, India's urban landscape continues to evolve rapidly. Bengaluru, Hyderabad, Pune and Chennai have become economic engines, powered by the technology sector. To accommodate global operations, IT companies are embracing flexible and extended work hours. This transition has resulted in a considerable rise in demand for late-night eateries, cloud kitchens, and food delivery services. However, the vast majority of these offerings are energy-dense, nutrient-poor food products. As a nightlife culture expands in parallel with economic ambitions, so too does the risk of a nutrition-driven public health crisis. While the numbers among IT professionals are eye-catching, the escalating burden of NCDs extends well beyond this sector. The message is clear: reversing the tide of NCDs demands not just awareness but action. Regulatory reforms, especially those addressing the food industry, are imperative. Imposing taxes on foods high in sugar and salt — or those failing to meet nutritional standards — could be a logical next step. After all, if there is one thing India has never shied away from, it is introducing new taxes. Why not one that promotes health? Dr. A. Chandiran Joseph is a doctor who is currently pursuing his post-graduation in community medicine in Chennai. The views expressed are personal
Yahoo
16-05-2025
- Business
- Yahoo
Second Head-to-head Phase 3 Study of Mazdutide versus Semaglutide Completes First Participant Dosing in Adults in China with Overweight or Obesity Accompanied Fatty Liver Disease (GLORY-3)
SAN FRANCISCO and SUZHOU, China, May 16, 2025 /PRNewswire/ -- Innovent Biologics, Inc. ("Innovent") (HKEX: 01801), a world-class biopharmaceutical company that develops, manufactures and commercializes high-quality medicines for the treatment of oncologic, autoimmune, cardiovascular and metabolic, ophthalmologic and other major diseases, announces that the first participant has been successfully dosed in GLORY-3, a Phase 3 clinical study of mazdutide (Innovent R&D Code: IBI362), a dual glucagon (GCG) and glucagon-like peptide 1 receptor (GLP-1) receptor agonist. The study targets adults in China with overweight or obesity accompanied metabolic dysfunction-associated fatty liver disease (MAFLD). GLORY-3 is a multicenter, randomized, open-label Phase 3 clinical study (NCT06884293) comparing the efficacy and safety of mazdutide versus semaglutide in Chinese adults with overweight or obesity accompanied MAFLD. This study plans to enroll approximately 470 participants with overweight or obesity (BMI ≥ 27 kg/m2) accompanied MAFLD, who will be randomized 1:1 to receive mazdutide 9 mg or semaglutide 2.4 mg. The primary endpoints are the percentage change in liver fat content (LFC) as measured by magnetic resonance proton density fat fraction (MRI-PDFF) and the percentage change in body weight from baseline to week 48. A Phase 2 study conducted in Chinese adults with obesity (BMI ≥ 30 kg/m2, NCT04904913) showed that after 48 weeks of treatment, mazdutide 9 mg achieved an 18.6% (17.8kg) placebo-adjusted mean percent reduction in body weight. Meanwhile, 51.2% and 34.9% of the subjects in the mazdutide 9 mg group achieved 15% or more and 20% or more weight loss from baseline, respectively. Among participants with baseline LFC≥ 5% (measured by MRI-PDFF), the percent change in LFC from baseline to week 24 was reduced by 73.3% in the mazdutide 9 mg group. This decrease was sustained during the 48-week extended treatment period, suggesting that mazdutide can effectively reduce body weight and liver fat in participants with overweight or obesity. Professor Lixin Guo, the Principal Investigator of the Study, Peking University People's Hospital, stated, "MAFLD is now the most common chronic liver disease in the world and has surpassed viral hepatitis as the leading chronic liver disease in China. Obesity is a key risk factor, with MAFLD affecting up to 81.8% people with obesity in China[1]. The latest Chinese guidelines recommended GLP-1 agents such as semaglutide for treating obesity and MAFLD ('Guideline for chronic weight management and clinical practice of anti-obesity medications'). As a dual GCG/GLP-1 receptor agonist, mazdutide 9 mg has shown strong weight loss effects and notable improvements in liver fat and enzyme levels, thanks to its additional GCG activity. GLORY-3 is the first clinical trial comparing a dual GCG/GLP-1 receptor agonist with a GLP-1R-only drug in Chinese adults with obesity. It will compare the efficacy and safety of mazdutide 9 mg versus semaglutide 2.4 mg in participants with overweight or obesity accompanied MAFLD. Together with our investigator team, I am committed to conducting this study to the highest standards and to delivering a better treatment option for the Chinese population with overweight or obesity accompanied MAFLD." Dr. Lei Qian, Senior Vice President of Clinical Development at Innovent, stated, "Mazdutide, as a dual GCG/GLP-1 receptor agonist, enhances lipolysis and fatty acid oxidation by stimulating the GCG receptor, offering a series of comprehensive metabolic benefits compared to GLP-1 single receptor agonist drugs. In our Phase 2 study conducted in Chinese adults with obesity, participants with baseline LFC ≥ 5% had a 73.3% reduction in liver fat content after 24 weeks of treatment with mazdutide 9 mg, which preliminarily demonstrated the efficacy of mazdutide in reducing liver fat content. I am very confident that mazdutide will continue to show strong clinical efficacy in the GLORY-3 study, including in weight loss and liver metabolism, and provide a better treatment option for Chinese patients with overweight or obesity accompanied MAFLD." About Obesity China has the world's largest population of people with overweight or obesity[2], with the obesity rate likely to rise. Obesity contributes to multiple comorbidities, reducing life expectancy and quality of life. In 2019, overweight and obesity accounted for 11.1% of deaths related from chronic non-communicable diseases in China, a significant increase from 5.7% in 1990[3]. As obesity is a chronic disease, it requires long-term management, and China faces a lack of long-term effective and safe treatments. Despite lifestyle interventions being the first-line treatment, many patients fail to achieve their desired weight loss goals, underscoring the need for more effective and safer pharmacological interventions. About MAFLD MAFLD is the most common chronic liver disease worldwide, with a global prevalence estimated around 32.4% and increasing. Obesity is one of the risk factors for MAFLD, and the prevalence of MAFLD in those with obesity worldwide has reached 75.3%. In China, MAFLD has overtaken viral hepatitis as the leading chronic liver condition, affecting 81.8% of obese individuals[1]. China also has the world's highest incidence of MAFLD in both normal and obese populations. Treatment goals include reducing body weight and waist circumference, improving insulin resistance, preventing and treating metabolic-related syndromes, and reversing fibrosis. For patients with MAFLD and overweight or obesity, combining lifestyle and pharmacological interventions is considered the most effective strategy to improve health outcomes and quality of life. About Mazdutide (IBI362) Innovent entered into an exclusive license agreement with Eli Lilly and Company (Lilly) for the development and potential commercialization of OXM3 (also known as mazdutide), a GLP-1R and GCGR dual agonist, in China. As a mammalian oxyntomodulin (OXM) analogue, mazdutide may offer additional benefits beyond those of GLP-1 receptor agonists—such as promoting insulin secretion, lowering blood glucose and reducing body weight—by also activating the glucagon receptor to increase energy expenditure and improve hepatic fat metabolism. Mazdutide has demonstrated excellent weight loss and glucose-lowering effects in clinical studies. It has also shown benefits in reducing waist circumference, blood lipids, blood pressure, blood uric acid, liver enzymes, and liver fat content, as well as improving insulin sensitivity. Mazdutide currently has two NDAs accepted for review by NMPA, including: For chronic weight management in adults with overweight of obesity; For glycemia control in adults with type 2 diabetes. Mazdutide is currently being evaluated in six Phase 3 clinical studies, including: GLORY-1: A Phase 3 trial in Chinese participants with overweight or obesity. GLORY-2: A Phase 3 trial in Chinese participants with moderate-to-severe obesity. GLORY-3: A Phase 3 trial comparing mazdutide and semaglutide in Chinese participants with overweight/obesity and metabolic dysfunction-associated fatty liver disease (MAFLD). DREAMS-1: A Phase 3 trial in treatment-naïve Chinese patients with T2D. DREAMS-2: A Phase 3 trial comparing mazdutide and dulaglutide in Chinese T2D patients with inadequate glycemic control on oral antidiabetic drugs. DREAMS-3: A Phase 3 trial comparing mazdutide and semaglutide in Chinese patients with T2D and obesity. Among these, GLORY-1, DREAMS-1 and DREAMS-2 studies have all met their endpoints. In addition, several new clinical studies of mazdutide are planned, including: A Phase 3 trial in adolescents with obesity. A Phase 3 trial in Chinese participants with moderate-to-severe obstructive sleep apnea (OSA) and obesity. New studies in metabolic dysfunction-associated steatohepatitis (MASH) and heart failure with preserved ejection fraction (HFpEF). About Innovent Innovent is a leading biopharmaceutical company founded in 2011 with the mission to empower patients worldwide with affordable, high-quality biopharmaceuticals. The company discovers, develops, manufactures and commercializes innovative medicines that target some of the most intractable diseases. Its pioneering therapies treat cancer, cardiovascular and metabolic, autoimmune and eye diseases. Innovent has launched 15 products in the market. It has 3 new drug applications under regulatory review, 4 assets in Phase III or pivotal clinical trials and 15 more molecules in early clinical stage. Innovent partners with over 30 global healthcare companies, including Eli Lilly, Sanofi, Incyte, Adimab, LG Chem and MD Anderson Cancer Center. Guided by the motto, "Start with Integrity, Succeed through Action," Innovent maintains the highest standard of industry practices and works collaboratively to advance the biopharmaceutical industry so that first-rate pharmaceutical drugs can become widely accessible. For more information, visit or follow Innovent on Facebook and LinkedIn. Statement: (1)Innovent does not recommend the use of any unapproved drug (s)/indication (s). （2）Ramucirumab (Cyramza) and Selpercatinib (Retsevmo) and Pirtobrutinib (Jaypirca) were developed by Eli Lilly and Company. Forward-looking statement This news release may contain certain forward-looking statements that are, by their nature, subject to significant risks and uncertainties. The words "anticipate", "believe", "estimate", "expect", "intend" and similar expressions, as they relate to Innovent, are intended to identify certain of such forward-looking statements. Innovent does not intend to update these forward-looking statements regularly. These forward-looking statements are based on the existing beliefs, assumptions, expectations, estimates, projections and understandings of the management of Innovent with respect to future events at the time these statements are made. These statements are not a guarantee of future developments and are subject to risks, uncertainties and other factors, some of which are beyond Innovent's control and are difficult to predict. Consequently, actual results may differ materially from information contained in the forward-looking statements as a result of future changes or developments in our business, Innovent's competitive environment and political, economic, legal and social conditions. Innovent, the Directors and the employees of Innovent assume (a) no obligation to correct or update the forward-looking statements contained in this site; and (b) no liability in the event that any of the forward-looking statements does not materialize or turn out to be incorrect. References [1] Chen K, Shen Z, Gu W, Lyu Z, Qi X, Mu Y, Ning Y; Meinian Investigator Group. Prevalence of obesity and associated complications in China: A cross-sectional, real-world study in 15.8 million adults. Diabetes Obes Metab. 2023 Nov;25(11):3390-3399. [2] Pan XF, Wang L, Pan A. Epidemiology and determinants of obesity in China. Lancet Diabetes Endocrinol 2021; 9: 373–92. [3] Institute for Health Metrics and Evaluation. Global Health Data Exchange. GBD results tool. (accessed Jan 10, 2021). View original content: SOURCE Innovent Biologics
Indian Express
02-05-2025
- Health
- Indian Express
Fatty liver disease goes down with novel weight loss drugs, shows new study: What does this mean for therapy?
Nearly two in three people with fatty liver disease lost some of the liver fat and inflammation after using semaglutide 2.4 mg weekly shots for one-and-a-half years, according to initial results from an ongoing phase 3 trial, published recently in the New England Journal of Medicine. Importantly, around one in three patients also saw reduction in liver fibrosis or scarring of the liver that prevents it from functioning properly. Metabolic dysfunction-Associated Steatotic Liver Disease (MAFLD) — until recently referred to as the Non-Alcoholic Fatty Liver Disease — is a chronic condition where there is an excessive build-up of fat on the liver. This fat accumulation leads to inflammation, scarring of the liver and may even cause liver cancer. The prevalence of MAFLD in India is estimated to be between 9% and 32%. Dr SK Sarin, liver specialist and vice-chancellor of the Institute of Liver and Biliary Sciences, talks about the significance of the findings. What do the results of the phase III trial tell us? This is a very important study, which builds on the findings of the phase 2 trial on the impact of semaglutide on MASLD. Phase 2 trials are usually done to fix the dosing and the highest 2.4 mg dose of the medicine was used for the current trial. The results show that 62.9% of the people on semaglutide saw a loss of liver fat and inflammation as compared to 34.3% among people given placebo. The stiffening of the liver also reduced in 36.8% of the participants on semaglutide as compared to 22.4% on placebo. The participants lost around 10% of their body weight in the current trial as compared to 14% recorded previously. All in all, the study shows promising results for fatty liver disease. How does the drug work? Are these the effects of weight loss? Semaglutide belongs to a class of medicines known as GLP-1 receptor agonists which mimic the action of certain gut hormones to improve secretion of insulin, inhibit secretion of glucagon that stimulates glucose production in the liver, and also reduce appetite by slowing down digestion. The study does not look into the confounding variable of weight loss, so we cannot say if there is any other reason for the improvements seen. However, it is well-known that when people lose weight, MASLD improves. People who lose around 7-10% of their body weight, see a reduction in liver fat. And, with a weight-loss of more than 10%, they see regression in fibrosis. This happens even if people lose weight without using these drugs. What is the current treatment for MASLD? What are the challenges? The best way to treat MASLD is weight loss — be it with drug or with diet and exercise. The drug is meant for people who are not able to move and exercise or are unable to lose weight with diet and exercise. They come with several side effects such as vomiting, nausea, and even serious side effects such as stomach paralysis, inflammation of the pancreas, and thyroid cancer. At present, there are three lines of treatment. One, of course, are the GLP-1 drugs that work on the gut hormones. Two, a drug called resmetirom that works on the thyroid hormone — this is again very expensive at around $ 5,400 a month. Third, FGF21 medicines that work on the adipose tissues. All of these medicines are meant to help with weight loss and thereby improve the liver.
