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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMASH / Liver DiseaseALT normalization rates on GLP-1 — what worked for you? Page 2

ALT normalization rates on GLP-1 — what worked for you?

rick_sfbay Wed, Jan 24, 2024 at 9:58 AM 10 replies 2,156 viewsPage 2 of 2
LibrarianMeg
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Jan 25, 2024 at 2:35 AM#6
labquiet_amy said:
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 331 dB/m (moderate steatosis) and stiffness 9.8 kPa (possible…

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: Jan 25, 2024 at 4:35 AM
43 13Dr.NateNeph, PharmD_Rodriguez, julia.endo and 40 others
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TirzTom
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Jan 25, 2024 at 9:10 AM#7
rick_sfbay said:
ALT was mildly raised at baseline, normalised at month five, and I now have no idea whether anything happened to the fibrosis that actually matters.

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.
42 12tom_AK, josh_phd_bmore, roxy_nash and 39 others
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Dr.CardioMD
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Jan 25, 2024 at 3:45 PM#8
LibrarianMeg said:
Liver ultrasound comparison for liver and MASH: my hepatologist ordered serial ultrasounds to track NAFLD regression.

Adding the part of the answer the thread has not reached. Take it one variable at a time. Almost every unanswerable question in these threads is unanswerable because three things changed in the same fortnight, and no amount of subsequent argument can untangle them after the fact.

41 11tony_orlando, Dr.NephBHM_UK, kim_atl_prep and 38 others
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KarenAZ_mom
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Jan 25, 2024 at 10:20 PM#9

A narrower follow-up, since the general answer is now clear:

What would you measure differently if you were starting again?

40 10LibrarianMeg, bri_stats, pete_manc_UK and 37 others
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rick_sfbay
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San Francisco, CA
Jan 27, 2024 at 5:59 AM#10

Reporting back.

For the archive: it took about six weeks rather than the two I expected, and the difference between those two numbers was the whole of my problem.

Last edited: Jan 27, 2024 at 11:59 AM
36 9Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 33 others
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