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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMASH / Liver DiseaseDe novo lipogenesis reduction on GLP-1 — anyone have experience?

De novo lipogenesis reduction on GLP-1 — anyone have experience?

FDA_TrackerJim Tue, May 6, 2025 at 7:57 PM 7 replies 1,424 viewsPage 1 of 2
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FDA_TrackerJim
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May 6, 2025 at 7:57 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.

What I am after is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.

I would rather have one careful answer than five confident ones.

2 22Dr.Martinez, mike_mod
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MikeFit_NJ
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New Jersey
May 6, 2025 at 8:13 PM#2
FDA_TrackerJim said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

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: May 6, 2025 at 11:13 PM
1 21marcus_mpls
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marco_milano
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Milan, IT
May 6, 2025 at 8:29 PM#3
MikeFit_NJ said:
Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 320 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 12 months: CAP dropped to 233 dB/m (minimal steatosis) and stiffness normalized to 5.6 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: May 7, 2025 at 12:29 AM
50 20Dr.LipidDallas, alex_tucson, kevin_tulsa and 47 others
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emily_PDX
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May 6, 2025 at 8:45 PM#4
FDA_TrackerJim said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Same experience, arrived at from the opposite direction. Posting only so the count is not one.

49 19Dr.KarenChen, Dr.NateNeph, PharmD_Rodriguez and 46 others
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jim_asheville
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Asheville, NC
May 6, 2025 at 10:11 PM#5

Adding the clinical framing, because it changes how the question reads.

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.
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