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.
What I actually want to know is 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.
lori_vegas 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 | 70 | 27 | 7-56 U/L |
| AST | 63 | 27 | 10-40 U/L |
| GGT | 80 | 31 | 9-48 U/L |
| ALP | 110 | 72 | 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.
Dr.SleepRoch said:Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).
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.
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View Resultslori_vegas said:Fatty liver on an incidental scan two years ago and nobody followed it up.
This is my experience too, for whatever a second data point is worth. The detail I would add is minor and it is already implied above.
Adding the clinical framing, because it changes how the question reads.
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 329 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible fibrosis). Diagnosed with NAFLD.
After 15 months: CAP dropped to 242 dB/m (minimal steatosis) and stiffness normalized to 5 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.