• Author
    Tiffany Nguyen
  • Discovery PI

    Vibha Singhal

  • Project Co-Author

    Song, Michelle (CUSM); Sundar, Shreya; Schenker, Rachel MD; Singhal, Vibha MD (UCLA)

  • Abstract Title

    Improvements in Liver Enzymes in Adolescents with Obesity using GLP-1 Receptor Analogs

  • Discovery AOC Petal or Dual Degree Program

    Basic, Clinical, & Translational Research

  • Abstract

    Background: Glucagon-like peptide-1 receptor agonists (GLP-1RA) are prescribed for adolescents with diabetes and obesity. In adults, evidence suggests GLP-1RA contributes to MASLD improvement on liver biopsy and imaging. MASLD treatment with GLP-1RA was recently approved by the FDA in adults, but data in adolescents is evolving.

    Objective: We aim to assess changes in alanine aminotransferase (ALT) in adolescents with obesity receiving GLP-1RA.

    Methods: Retrospective analysis of adolescents seen at our clinics in 2023-2025 who were started on a GLP-1RA with follow-up labs at 6 and/or 12 months. Elevated ALT was defined as 2x the upper limit of normal (ULN), >44 for girls and >52 for boys. Weight, body mass index (BMI), and ALT levels at the start of GLP-1RA initiation, 6 months, and 12 months were analyzed via nonparametric tests. 

    Results: We identified 48 adolescents (29 females, 19 males). Median weight decreased from 94.8 kg at baseline to 86.0 kg at 6 months (p<0.001) and remained lower at 12 months (90.8 kg, p=0.0014). Median BMI declined from 36.3 to 32.0 kg/m² at 6 and 12 months (p<0.001). Median ALT improved from 28 to 21 U/L at 6 months (p=0.0006).  Among the 48 adolescents, we identified 11 with elevated initial ALT (>2x ULN) level. Of the 11, 3 improved to <2x ULN by 6 months of GLP-1RA use, 4 more by 12 months, and 2 others showed downward ALT trends. Interestingly, ALT improvement negatively correlated with weight loss in patients with elevated initial ALT (Spearman Rho = -0.667; P = 0.049); however, association lost after controlling for initial BMI.

    Conclusions: GLP-1RA is a potential therapeutic agent for adolescents with MASLD; however, larger cohort studies are needed to validate these findings. In the future, we hope to compare the effects of GLP-1RA on ALT levels to other weight loss agents and incorporate social and behavioral determinants of health into our data.

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