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 narrow version of the question is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.
Practical detail welcome, however dull — the duller the better.
dan_philly said:Fatty liver on an incidental scan two years ago and nobody followed it up.
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 325 dB/m (moderate steatosis) and stiffness 9.8 kPa (possible fibrosis). Diagnosed with NAFLD.
After 11 months: CAP dropped to 228 dB/m (minimal steatosis) and stiffness normalized to 6.1 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.
Dr.SleepRoch said:Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 325 dB/m (moderate steatosis) and stiffness 9.8 kPa (possible…
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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Shop Reference Standardsdan_philly said:Fatty liver on an incidental scan two years ago and nobody followed it up.
This matches mine closely enough to be worth saying so out loud. Posting only so the count is not one.
Clinical perspective, offered as context rather than as advice.
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.