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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMASH / Liver DiseaseHas anyone dealt with glp-1 hepatoprotection?

Has anyone dealt with glp-1 hepatoprotection?

GenomicsKate Fri, Jul 11, 2025 at 12:32 PM 33 replies 1,678 viewsPage 1 of 7
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GenomicsKate
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Jul 11, 2025 at 12:32 PM#1

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 I am after 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.

42 12DebRD_ATL, KristenIndy, MarkLI_maint and 39 others
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PurityPaulOR
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Jul 11, 2025 at 12:56 PM#2
GenomicsKate 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 340 dB/m (moderate steatosis) and stiffness 9.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 14 months: CAP dropped to 243 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.

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BrianDallas92
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Jul 11, 2025 at 1:20 PM#3
PurityPaulOR said:
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 340 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.

References:
[1] Sanyal AJ, et al. N Engl J Med. 2024.
Last edited: Jul 11, 2025 at 2:20 PM
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adam_van
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Jul 11, 2025 at 1:44 PM#4
GenomicsKate said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Same pattern here, and in the same order.

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Dr.ObesityMed
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Jul 11, 2025 at 3:57 PM#5

From the other side of the consultation, briefly.

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.

Last edited: Jul 11, 2025 at 9:57 PM
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