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ForumsMASH / Liver DiseaseDe novo lipogenesis reduction on GLP-1 — my results so far

De novo lipogenesis reduction on GLP-1 — my results so far

DadBodDave Sat, Aug 17, 2024 at 6:42 PM 14 replies 2,052 viewsPage 1 of 3
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DadBodDave
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Nov 2024
Ohio
Aug 17, 2024 at 6:42 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.

Not looking for reassurance. Looking for the part I have got wrong.

43 13laura_annarbor, JenMemphis, pat_auckland and 40 others
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InsuranceTom
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Mar 2024
Connecticut
Aug 17, 2024 at 8:15 PM#2
DadBodDave 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.
Last edited: Aug 18, 2024 at 1:15 AM
42 12lucas_SP_BR, lisa_labSD, adam_van and 39 others
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Dr.EndoEP
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El Paso, TX
Aug 17, 2024 at 9:48 PM#3
InsuranceTom 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 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.

41 11FranDenver, Dr.BariatricHTX, LindaRN_retired and 38 others
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anna.melb_AU
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Apr 2024
Melbourne, AU
Aug 17, 2024 at 11:21 PM#4
DadBodDave said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Can confirm. Same sequence, different timescale.

40 10tammy_FL, Dr.LipidDallas, alex_tucson and 37 others
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claudia_zurich
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Zurich, CH
Aug 18, 2024 at 8:24 AM#5

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

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 316 dB/m (moderate steatosis) and stiffness 9.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 14 months: CAP dropped to 239 dB/m (minimal steatosis) and stiffness normalized to 5.2 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.

39 9kevin_tulsa, Dr.PainCLE, mike_mealprep and 36 others
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