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Mazdutide Ameliorates Metabolic Dysfunction-Associated Steatotic Liver Disease by Modulating Endoplasmic Reticulum Stress, Improving Lipid Metabolism and Alleviating Inflammation.

Gan L, Duan L, Zheng X.
Pharmaceuticals (Basel, Switzerland) · February 26, 2026
Plain-language summary

This study investigated whether mazdutide, a dual GLP-1/glucagon receptor agonist previously studied for weight and metabolic management, could reduce early-stage metabolic dysfunction-associated steatotic liver disease (MASLD). Researchers used two model systems: mice fed a high-fat diet for 12 weeks (then treated with subcutaneous mazdutide for 4 weeks) and hepatocytes exposed to free fatty acids in cell culture (then co-treated with mazdutide or an ER stress inhibitor). The study measured blood and liver lipid profiles, liver injury markers, inflammatory cytokines, oxidative stress indicators, and liver histology, as well as protein expression linked to endoplasmic reticulum (ER) stress, inflammation, and lipid metabolism. The authors report that mazdutide treatment was associated with improved lipid metabolism, reduced hepatic steatosis, lower liver injury markers, and decreased inflammation and oxidative stress in both the animal and cell models. Mechanistically, the authors propose that mazdutide acts at least partly by dampening ER stress pathways. Key limitations include the exclusive use of preclinical models (no human subjects), a single mouse strain/diet protocol, and the early-stage disease focus, meaning translation to human MASLD remains unestablished.

Why this grade: All efficacy data derive from a high-fat diet mouse model and an in vitro hepatocyte model; no human subjects were included, limiting direct clinical translation.

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Abstract

Background: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is the most prevalent chronic liver disorder globally. Mazdutide has shown clinical benefits in weight management and metabolic regulation, indicating its potential as a therapeutic agent for MASLD. This study aimed to investigate the efficacy and mechanism of action of Mazdutide against early-stage MASLD. Methods: A MASLD mouse model was induced by a 12-week high-fat diet, followed by a 4-week treatment with subcutaneous Mazdutide (100, 200, or 400 μg/kg). In vitro, a cellular MASLD model was established by treating hepatocytes with 1 mM free fatty acids for 24 h, followed by co-treatment with Mazdutide (10, 20, or 50 nM) or the endoplasmic reticulum (ER) stress inhibitor 4-phenylbutyric acid (4-PBA). Serum and hepatic lipid profiles, liver injury markers, and pro-inflammatory cytokines were quantified. Liver histopathology was assessed by hematoxylin and eosin and Oil Red O staining. Protein expression related to ER stress, inflammation, and lipid metabolism was analyzed by immunohistochemistry and Western blot. Results: Compared with the MASLD model group, Mazdutide treatment significantly ameliorated systemic and hepatic lipid metabolism disorders, reduced liver injury markers and hepatic steatosis, and mitigated inflammation and oxidative stress in MASLD mice and hepatocytes ( p p Conclusions: Our findings demonstrate that Mazdutide alleviates hepatic ER stress in MASLD, suppresses inflammatory responses and improved lipid metabolism, which ultimately attenuates disease progression.

Educational summary of published research — not medical advice. License: cc by. Full text is shown only where licensing permits.