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Study · Systematic review · 2026

2 results

Weight Loss as a Determinant of Histological Improvement in Metabolic Dysfunction-Associated Steatotic Liver Disease in People With Obesity. A Systematic Review and Network Meta-Analysis of Randomised Clinical Trials.

Monami M, Belluzzi A, Buscemi S, Busetto L, Cohen R, De Luca M, Galli A, Mannucci E, Petry TZ, Ragghianti B, Sbraccia P, Dicker D

Diabetes, obesity & metabolism9 Mar 2026Cited by 5 (Europe PMC)

PMID41804193 (opens in a new tab)PMCIDPMC13071265 (opens in a new tab)DOI10.1111/dom.70617 (opens in a new tab)PepBankPUB-41804193
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Summary

BackgroundMetabolic dysfunction-associated steatotic liver disease (MASLD) is closely linked to obesity and insulin resistance, and sustained weight loss is associated with histological improvement. Whether different obesity-management modalities exert weight-independent hepatic effects remains uncertain.MethodsWe conducted a systematic review and network meta-analysis (NMA) of randomised controlled trials evaluating lifestyle intervention, obesity management medications, endoscopic sleeve gastroplasty and metabolic and bariatric surgery in adults with BMI ≥ 27 kg/m2 and biopsy-confirmed MASH. The primary endpoint was MASH resolution without worsening of fibrosis. Study-level meta-regressions explored associations between total body weight loss (TBWL%) and histologic outcomes.ResultsSix RCTs (n = 1379) met inclusion criteria. Tirzepatide, semaglutide, sleeve gastrectomy and Roux-en-Y gastric bypass were superior to placebo or standard care for achieving MASH resolution. Because the network was weakly connected and largely placebo-anchored, indirect estimates were imprecise. Across study arms, greater TBWL% was associated with higher rates of MASH resolution and fibrosis improvement; however, these associations were strongly influenced by a small number of high-weight-loss surgical arms.ConclusionsWeight loss was consistently associated with histologic improvement across available RCTs. However, the limited evidence base, sparse network structure and ecological nature of the meta-regression preclude causal inference. These findings should be considered exploratory and hypothesis-generating, underscoring the need for adequately powered head-to-head trials.
CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study2

2 results from studies that gave the peptide. 2 results from people.

  1. 01HumanSystematic reviewEfficacy outcome

    In adults with obesity and biopsy-confirmed MASH, tirzepatide was superior to placebo or standard care for achieving MASH resolution in a network meta-analysis of six trials.

    In plain wordsIn adults with obesity and MASH, tirzepatide led to MASH resolution more often than placebo or standard care in a network meta-analysis.

    Peptide
    Tirzepatide
    Outcome
    IncreaseMASH resolution
    Study

    n: not reported in source

    Comparator
    Placebo or standard care
    Outcome group
    Liver fat and liver function · Liver
    Studied dose
    Dose not stated

    Source sentences

    Summary
    Tirzepatide, semaglutide, sleeve gastrectomy and Roux-en-Y gastric bypass were superior to placebo or standard care for achieving MASH resolution.
    1 context sentence
    Summary · context
    We conducted a systematic review and network meta-analysis (NMA) of randomised controlled trials evaluating lifestyle intervention, obesity management medications, endoscopic sleeve gastroplasty and metabolic and bariatric surgery in adults with BMI ≥ 27 kg/m2 and biopsy-confirmed MASH.
  2. 02HumanSystematic reviewEfficacy outcome

    In adults with obesity and biopsy-confirmed MASH, semaglutide was superior to placebo or standard care for achieving MASH resolution in a network meta-analysis of six trials.

    In plain wordsIn adults with obesity and MASH, semaglutide led to MASH resolution more often than placebo or standard care in a network meta-analysis.

    Peptide
    Semaglutide
    Outcome
    IncreaseMASH resolution
    Study

    n: not reported in source

    Comparator
    Placebo or standard care
    Outcome group
    Liver fat and liver function · Liver
    Studied dose
    Dose not stated

    Source sentences

    Summary
    Tirzepatide, semaglutide, sleeve gastrectomy and Roux-en-Y gastric bypass were superior to placebo or standard care for achieving MASH resolution.
    1 context sentence
    Summary · context
    We conducted a systematic review and network meta-analysis (NMA) of randomised controlled trials evaluating lifestyle intervention, obesity management medications, endoscopic sleeve gastroplasty and metabolic and bariatric surgery in adults with BMI ≥ 27 kg/m2 and biopsy-confirmed MASH.

AI wrote and checked these results. AI can make mistakes, so check important results against the source.

Version history

PepBank keeps every version of the data on this study. Status changes from Retraction Watch, Europe PMC and Crossref are listed with their source.

  1. Version 3Current

    11 Oct 2026, 00:04 UTC

    Study results updated

  2. Version 2

    9 Oct 2026, 03:07 UTC

    Study data updated · source update from Europe PMC

  3. Version 1

    9 Oct 2026, 03:06 UTC

    First added · source update from Europe PMC

Subjects

Terms as the source lists them.

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