🍪 The GLP Lounge uses cookies to improve your experience, analyze traffic, and personalize content. By continuing to use this site, you agree to our Cookie Policy.
Evidence-based GLP-1 & peptide discussion since 2023
ForumsMASH / Liver DiseaseHepatic steatosis grading on ultrasound — what your results mean

Hepatic steatosis grading on ultrasound — what your results mean

Dr.GastroMayo Sat, May 23, 2026 at 3:09 PM 4 replies 366 viewsPage 1 of 1
Dr.GastroMayo
VIP Member
2,345
13,456
Jan 2024
Mayo Clinic, MN
May 23, 2026 at 3:09 PM#1

A reference post rather than a discussion. Corrections are the point; I would rather this be right than mine. It is about liver and MASH, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

The liver data is among the strongest non-weight findings in the class. The semaglutide MASH programme reported a large advantage over placebo on MASH resolution, with a substantial minority also achieving fibrosis improvement — and fibrosis is the endpoint that predicts outcomes. Mechanistically it is reduced hepatic lipogenesis, increased fatty-acid oxidation, less hepatic inflammation, and possibly a direct effect on stellate-cell activation.

The condition it depends on

ALT falling is not the same as fibrosis improving. Enzymes are a crude proxy; FIB-4 or elastography is what tells you about the thing that matters.

The practical version

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.

What I am not sure about

What would genuinely help is knowing whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is. Practical detail welcome, however dull — the duller the better.

— Dr.GastroMayo · corrections welcome and will be edited into this post with credit
8 3mike_nyc, VendorMark, COA_Karl and 5 others
Reply Quote Save Share Report
DataDave
Senior Member
1,678
8,901
Apr 2024
Washington
Online
May 23, 2026 at 4:58 PM#2
Dr.GastroMayo said:
The liver data is among the strongest non-weight findings in the class.

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: May 23, 2026 at 5:58 PM
7 2mike_nyc, VendorMark, COA_Karl and 4 others
Reply Quote Save Share Report
RetaRick_CA
VIP Member
2,012
9,876
Jan 2024
California
May 23, 2026 at 6:47 PM#3
Dr.GastroMayo said:
The liver data is among the strongest non-weight findings in the class.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 336 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 10 months: CAP dropped to 229 dB/m (minimal steatosis) and stiffness normalized to 5.7 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.

6 1DadBodDave, AmyNC_wife, SkepticalSean and 3 others
Reply Quote Save Share Report

Sigma-Aldrich — Research-Grade Standards

Certified reference materials, analytical reagents, and research-grade standards for peptide verification. Trusted by laboratories worldwide.

Shop Reference Standards
Dr.RenalNash
VIP Member
1,234
7,890
Mar 2024
Nashville, TN
May 23, 2026 at 8:36 PM#4
RetaRick_CA said:
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 336 dB/m (moderate steatosis) and stiffness 8.8 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.

5 0anders_CPH, Dr.NutriCornell, pam_stl and 2 others
Reply Quote Save Share Report
RickReta_CO
Member
312
1,234
Jan 2025
Colorado
May 24, 2026 at 7:22 AM#5
DataDave 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…

This is my experience too, for whatever a second data point is worth.

4 24LindaRN_retired, tommy_boulder, hyun_seoul and 1 other
Reply Quote Save Share Report

Similar Threads

Survodutide MASH Phase 2b — histological improvement data9 replies
Semaglutide and MASH — liver fat reduction quantification13 replies
Non-invasive MASH biomarkers — FibroScan, ELF, FIB-4 on GLP-110 replies
ALT normalization rates on GLP-1 — pooled trial data20 replies
GLP-1 hepatoprotection — direct vs indirect mechanisms16 replies
ForumsNewTrendingMembersAccount

Log In

Forgot password?
No account? Register