B0508 - NASH Clinic; A Multidisciplinary Team Approach to Assess the Efficacy of Diet, Lifestyle and GLP1 Agonists

Yara Dababneh, MD, Tarek Badawi, BSc, Humberto Gonzalez, MD, Deepak Venkat, MD
Henry Ford Hospital, Detroit, MI

Introduction: Non-Alcoholic Steatohepatitis (NASH) is associated with increased morbidity and mortality. In this abstract, we will discuss the impact of a multidisciplinary team approach including diet and Glucagon Like Peptide-1 (GLP-1) agonists on improving comorbidities and NASH.

Methods: This is a retrospective study conducted at a large tertiary care center. Data were collected from 5/2019 to 12/2021 amidst patients with NASH, with or without liver biopsies, who are diagnosed with Type 2 Diabetes Mellitus (DM). Patients were identified at first clinic follow up and at their 12 month follow up after initiation of therapy with GLP-1 agonist, mainly Liraglutide and Simagultide for at least 6 months. Data on baseline characteristics and demographics were collected.



Results: Our study included a total of 28 patients with NASH cirrhosis, only 6 with biopsy proven NASH. Patients had a mean body weight of 115kgs with a mean BMI of 39.78 kg/m² at first clinic follow up compared to a mean BMI of 38.25 at the 1 year follow up. All patients followed up with our NASH clinic dietician and were complaint with GLP-1 therapy for at least 6 consecutive months. Patients had a statistically significant (p< 0.0001) reduction in A1c (Table 1). All other laboratory values were not statistically significant, although they were associated with a remarkable decrease at the 1 year follow up. Simaglutide and Liraglutide were compared and there was also no statistical significance associated with the use of either. We performed Subgroup analysis to compare lab values between patients who met 5% weight loss according to BMI and those who did not at 1 year follow up, A1c was again statistically significant among both groups with P< 0.05.

Discussion: Recent studies have indicated that central obesity and insulin resistance are the major factors leading to the development of NASH. It is thought to be related to fat deposition in hepatocytes that will increase insulin resistance. NASH treatment is believed to be multimodal similar to what was applied at our institution, including a combination of lifestyle adjustments and drug therapy for all associated chronic illnesses and comorbidities. In the last few years there have been promising outcomes with the use Glucagon-like peptide-1 (GLP-1) receptor agonists in improving hepatic outcomes in patients with NASH, as they can impact both DM and NASH through their dual effect on glycemic control and weight reduction leading to improved outcomes and slowing the progression of NASH.









Disclosures:


Yara Dababneh, MD, Tarek Badawi, BSc, Humberto Gonzalez, MD, Deepak Venkat, MD. B0508 - NASH Clinic; A Multidisciplinary Team Approach to Assess the Efficacy of Diet, Lifestyle and GLP1 Agonists, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.