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ForumsMASH / Liver DiseaseMASH prevalence in GLP-1 users — my results so far

MASH prevalence in GLP-1 users — my results so far

roxy_nash Thu, Apr 9, 2026 at 3:18 PM 6 replies 636 viewsPage 1 of 2
roxy_nash
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Apr 9, 2026 at 3:18 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.

The bit I cannot resolve on my own is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.

Tell me what I have not thought of.

44 14josh_phd_bmore, roxy_nash, tony_orlando and 41 others
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mike_nyc
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Apr 9, 2026 at 3:26 PM#2
roxy_nash said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy. The Phase 2b data for semaglutide showed 59% NASH resolution (vs 17% placebo) with 43% achieving fibrosis improvement[1].

Mechanism: GLP-1R activation reduces hepatic lipogenesis, increases fatty acid oxidation, reduces hepatic inflammation, and may directly reduce hepatic stellate cell activation (fibrosis pathway).

With resmetirom (thyroid hormone receptor agonist) recently approved for NASH, the field is evolving rapidly. Combination approaches (GLP-1 + resmetirom) are being explored.

References:
[1] Newsome PN, et al. N Engl J Med. 2021;384(12):1113-1124.
Last edited: Apr 9, 2026 at 7:26 PM
43 13stefan_berlin, Dr.EM_Chicago, pete_RVA and 40 others
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fiona_glasgow
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Apr 9, 2026 at 3:34 PM#3
mike_nyc said:
NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy.

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.

42 12KevinCompounds, TirzTom, TrialTracker_MD and 39 others
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tony_orlando
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Apr 9, 2026 at 3:42 PM#4
roxy_nash said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Mine went the same way, slower.

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claudia_zurich
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Apr 9, 2026 at 4:24 PM#5

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

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 9 months on GLP-1 therapy:

MarkerBaselineCurrentNormal Range
ALT62297-56 U/L
AST652510-40 U/L
GGT92379-48 U/L
ALP1128444-147 U/L

FibroScan also improved — liver stiffness from 8.5 kPa to 6.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

40 10kevin_tulsa, Dr.PainCLE, mike_mealprep and 37 others
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