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.
The question I want answered is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.
Not looking for reassurance. Looking for the part I have got wrong.
JessicaH_TX 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 6 months on GLP-1 therapy:
| Marker | Baseline | Current | Normal Range |
|---|---|---|---|
| ALT | 59 | 26 | 7-56 U/L |
| AST | 62 | 26 | 10-40 U/L |
| GGT | 89 | 34 | 9-48 U/L |
| ALP | 109 | 81 | 44-147 U/L |
FibroScan also improved — liver stiffness from 8.5 kPa to 5.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.
SarahChen_PharmD said:Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).
Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.
Baseline: "Moderate hepatic steatosis, liver span 17.2cm, echogenic texture consistent with fat infiltration"
Month 8: "Mild steatosis, liver span 15.8cm, improved echogenicity"
Month 14: "Minimal to no steatosis, normal liver span 14.5cm, normal echotexture"
My liver literally shrank and de-fattened. The ultrasound tech said she's seen this pattern increasingly in GLP-1 patients and it's remarkable how consistently the fatty liver resolves.
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Shop Reference StandardsJessicaH_TX said:Fatty liver on an incidental scan two years ago and nobody followed it up.
Second this. The detail I would add is minor and it is already implied above.
Clinical perspective, offered as context rather than as advice.
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 330 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible fibrosis). Diagnosed with NAFLD.
After 10 months: CAP dropped to 233 dB/m (minimal steatosis) and stiffness normalized to 5.1 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.