Fatty liver on an incidental scan two years ago and nobody followed it up. Now that I am losing weight I would like to know what to re-measure.
With resmetirom now available for MASH, combination approaches are being explored, so the standard of care in this area is moving faster than most threads assume.
What would genuinely help is knowing whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.
If the honest answer is that nobody knows, that is a useful answer and I would rather have it.
BiostatsBrad said:Fatty liver on an incidental scan two years ago and nobody followed it up.
Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 9 months on GLP-1 therapy:
| Marker | Baseline | Current | Normal Range |
|---|---|---|---|
| ALT | 67 | 29 | 7-56 U/L |
| AST | 55 | 27 | 10-40 U/L |
| GGT | 92 | 31 | 9-48 U/L |
| ALP | 102 | 84 | 44-147 U/L |
FibroScan also improved — liver stiffness from 8.5 kPa to 6.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.
BariatricNurseD said:Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 322 dB/m (moderate steatosis) and stiffness 9.8 kPa (possible fibrosis). Diagnosed with NAFLD.
After 14 months: CAP dropped to 235 dB/m (minimal steatosis) and stiffness normalized to 5.8 kPa. Hepatologist says the liver is essentially healing itself as the metabolic stress resolves.
GLP-1 agonists may become first-line NASH therapy. The Phase 3 data on semaglutide for NASH is very promising.
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View ResultsBiostatsBrad said:Fatty liver on an incidental scan two years ago and nobody followed it up.
Same pattern here, and in the same order.
Adding the clinical framing, because it changes how the question reads.
ATTAIN trial (survodutide) context for liver and MASH: survodutide, a GLP-1/glucagon dual agonist, showed -18.7% body weight at 46 weeks in the Phase 3 ATTAIN trial. NASH resolution was achieved in ~60% of patients[1].
This is relevant to liver and MASH because survodutide's glucagon agonism specifically targets hepatic lipid metabolism — making it potentially the best-in-class agent for NASH/MAFLD comorbid with obesity.
[1] Sanyal AJ, et al. N Engl J Med. 2024.