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ForumsMASH / Liver DiseaseGLP-1 hepatoprotection — my results so far

GLP-1 hepatoprotection — my results so far

lori_vegas Tue, Jan 9, 2024 at 3:54 PM 14 replies 2,207 viewsPage 1 of 3
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lori_vegas
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Las Vegas, NV
Jan 9, 2024 at 3:54 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 actually want to know is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.

If the honest answer is that nobody knows, that is a useful answer and I would rather have it.

34 4amy_econ_NJ, bbq_ray_KC, oliver_london and 31 others
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Dr.SleepRoch
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Rochester, MN
Jan 9, 2024 at 4:04 PM#2
lori_vegas said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

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
ALT70277-56 U/L
AST632710-40 U/L
GGT80319-48 U/L
ALP1107244-147 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.

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KetoKyle
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Utah
Jan 9, 2024 at 4:14 PM#3
Dr.SleepRoch said:
Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).

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: Jan 9, 2024 at 5:14 PM
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LondonLisa
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Jan 9, 2024 at 4:24 PM#4
lori_vegas said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

This is my experience too, for whatever a second data point is worth. The detail I would add is minor and it is already implied above.

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sarah_TO
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Toronto, CA
Jan 9, 2024 at 5:13 PM#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 329 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 15 months: CAP dropped to 242 dB/m (minimal steatosis) and stiffness normalized to 5 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.

30 0DanielChem_CHI, marco_milano, pam_columbus and 27 others
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