A liverfirst approach includes: Confirming liver involvement with imaging and fibrosis assessments Evaluating comorbid metabolic conditions Tailoring lifestyle guidance to support hepatic outcomes Initiating GLP1s where appropriate for both metabolic and liver health Monitoring ALT/AST and noninvasive fibrosis scores alongside traditional outcomes Even in patients with normal A1C or lean body type, these therapies can play a role
However, both injections increase the risk of gastrointestinal disorders, and the risk of tirzepatide is greater than that of liraglutide
These variables meaningfully influence both efficacy and safety, including cardiovascular risk, thrombotic events, and metabolic response
Nat Rev Gastroenterol Hepatol 10:33044
L., Koch, M., Mingrone, G., le Roux, C