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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMASH / Liver DiseaseHas anyone dealt with de novo lipogenesis reduction on glp-1? Page 2

Has anyone dealt with de novo lipogenesis reduction on glp-1?

NurseLeah_Nash Tue, Nov 18, 2025 at 1:33 AM 34 replies 1,698 viewsPage 2 of 7
Dr.BariatricHTX
Senior Member
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Feb 2024
Houston, TX
Nov 19, 2025 at 8:34 AM#6
KevinCompounds said:
Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 11 months on GLP-1 therapy:

MarkerBaselineCurrentNormal Range
ALT76237-56 U/L
AST592710-40 U/L
GGT76399-48 U/L
ALP1068344-147 U/L

FibroScan also improved — liver stiffness from 10.5 kPa to 6.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

35 5CarlaRPh_TPA, steph_laguna, fiona_glasgow and 32 others
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jason_paloalto
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Nov 2024
Palo Alto, CA
Nov 19, 2025 at 8:58 PM#7
NurseLeah_Nash said:
ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 332 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 12 months: CAP dropped to 225 dB/m (minimal steatosis) and stiffness normalized to 5.3 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.

Last edited: Nov 20, 2025 at 1:58 AM
34 4Dr.PathRoch, mona_PHX, andrew_nyc and 31 others
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Dr.LeslieOBGYN
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May 2024
Dallas, TX
Nov 20, 2025 at 9:22 AM#8
Dr.BariatricHTX said:
Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).

Adding the part of the answer the thread has not reached. The useful move here is to separate what is established from what is widely repeated. Those two sets overlap less than the confident tone of most write-ups suggests, and the second set is where nearly all the disagreement on this board comes from.

Last edited: Nov 20, 2025 at 3:22 PM
33 3james_edin, FranDenver, Dr.BariatricHTX and 30 others
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paige_pharma
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Sep 2024
Omaha, NE
Nov 20, 2025 at 9:46 PM#9

One thing that is still open after rick_sfbay’s answer:

How would you tell the difference between that and the alternative explanation?

32 2lisa_labSD, adam_van, Dr.SurgeonPGH and 29 others
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NurseLeah_Nash
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Nashville, TN
Nov 23, 2025 at 9:19 AM#10

Reporting back.

Coming back a few months on. It held. Nothing dramatic to report, which is the report.

14 12Dr.NateNeph, PharmD_Rodriguez, julia.endo and 11 others
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