De novo lipogenesis reduction on GLP-1 — mechanistic hepatology

MASHdoc_SA said:

The liver data is among the strongest non-weight findings in the class.

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 8 months on GLP-1 therapy:

FibroScan also improved — liver stiffness from 10.5 kPa to 5.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

Following on from Dr.KarenChen — and this may be the naive question:

What would you measure differently if you were starting again?

wendy_avl said:

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 315 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 13 months: CAP dropped to 238 dB/m (minimal steatosis) and stiffness normalized to 5.1 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.

Reporting back.

Update, and it is the boring outcome: nothing was wrong. The measurement I was reading had moved less than its own week-to-week variation, which somebody said upthread and I did not believe.

Dr.ObesityMed said:

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 315 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible…

That is correct as far as it goes, and here is where it stops going. Yes, and the corollary is less popular: if the reasoning holds, it also holds where it produces an answer we do not like.