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ForumsMASH / Liver DiseaseMASH prevalence in GLP-1 users — 6 month update

MASH prevalence in GLP-1 users — 6 month update

CryptoCarl Tue, Sep 24, 2024 at 4:37 PM 12 replies 1,822 viewsPage 1 of 3
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CryptoCarl
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May 2024
Arizona
Sep 24, 2024 at 4:37 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.

The question I want answered 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.

5 0CryptoCarl, MariaRD, AussieAnna and 2 others
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DebRD_ATL
Senior Member
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Feb 2024
Atlanta, GA
Sep 24, 2024 at 4:47 PM#2
CryptoCarl said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

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.
4 24RegAffairsDC, BiostatsBrad, PeptideSynthNJ and 1 other
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RetaRick_CA
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Sep 24, 2024 at 4:57 PM#3
DebRD_ATL said:
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…

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 10 months on GLP-1 therapy:

MarkerBaselineCurrentNormal Range
ALT79267-56 U/L
AST522010-40 U/L
GGT69329-48 U/L
ALP997644-147 U/L

FibroScan also improved — liver stiffness from 9.5 kPa to 5.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

Last edited: Sep 24, 2024 at 5:57 PM
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Dr.EndoEP
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Oct 2024
El Paso, TX
Sep 24, 2024 at 5:07 PM#4
CryptoCarl said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Adding a me-too, because a thread of one person's experience is not much use. The detail I would add is minor and it is already implied above.

2 22Dr.BariatricHTX, LindaRN_retired
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SleepDoc_PDX
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Sep 2024
Portland, OR
Sep 24, 2024 at 5:57 PM#5

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

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.

1 21mel_PDX
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