Abstract:Objective To evaluate the clinical efficacy and safety of glucagon like peptide-1 (GLP-1) analogue combined with metformin in the treatment of type 2 diabetes mellitus (T2DM) complicated with metabolic-related fatty liver disease(MAFLD). Methods All randomized controlled trials (RCTs) literatures of GLP-1 receptor agonist combined with metformin in the treatment of T2DM with MAFLD were searched in PubMed, Cochrane, Embase, CNKI, Wanfang, VIP, CBM and other databases from inception until April 2021. For the included literature data, Cochrane scale was used for quality evaluation, and Revman 5.3 software was used for analysis. Results In 7 RCTs Chinese literature, 640 patients were enrolled, including experimental group and control group. GLP-1 analogue combined with metformin was given in experimental group, and metformin alone was used in control group. The meta-analysis results showed that the efficacy in reducing the levels of fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in experimental group was significantly higher than those in control group (P<0.01, P<0.05). There was no significant difference in the incidence of adverse reactions between two groups (P>0.05). Conclusion In the treatment of T2DM complicated with MAFLD, GLP-1 receptor agonist combined with metformin is more effective than metformin alone in reducing the levels of blood glucose and blood lipid, and improving liver function, but does not increase the incidence of adverse reactions.