Do Patients on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Require Longer Fasting Prior to Vibration Controlled Transient Elastography?
prospective_cohort · Level II
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- Record sourced from PubMed, PMID 42678758.
- Also identified by DOI 10.14309/ajg.0000000000004191.
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Abstract
Vibration-controlled transient elastography (VCTE) requires a three-hour fasting period to minimize postprandial increases in liver stiffness measurement (LSM), but this recommendation predates widespread use of glucagon-like peptide-1 receptor agonists (GLP-1-RAs), which alter gastric emptying and postprandial hemodynamics. We evaluated whether current fasting guidance remains valid in 23 participants, including 12 with cirrhosis, receiving GLP-1 RAs who underwent serial LSM following standardized meal ingestion. LSM increased 20.6% at 30-60 minutes but fell back to <10% by 3 hours. Most patients returned to baseline by 3-4 hours, supporting adequacy of a three-hour fast, however, some patients required 4 hours for full return to baseline.