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ForumsMASH / Liver DiseaseMASH prevalence in GLP-1 users — what worked for you?

MASH prevalence in GLP-1 users — what worked for you?

claudia_zurich Mon, Dec 8, 2025 at 7:23 PM 12 replies 1,032 viewsPage 1 of 3
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claudia_zurich
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Jul 2024
Zurich, CH
Dec 8, 2025 at 7:23 PM#1

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.

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 actually want to know 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.

44 14emma_london, tammy_FL, Dr.LipidDallas and 41 others
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julia.endo
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Cincinnati, OH
Dec 8, 2025 at 7:53 PM#2
claudia_zurich 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.

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.
43 13mark_tokyo, hans_munich, jason_sac26 and 40 others
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Dr.DermMIA
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Miami, FL
Dec 8, 2025 at 8:23 PM#3
julia.endo 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 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
ALT55277-56 U/L
AST532510-40 U/L
GGT80379-48 U/L
ALP1007244-147 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.

42 12A1cHero_PHX, Dr.RenalNash, LipidDoc_ATL and 39 others
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SleepDoc_PDX
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Sep 2024
Portland, OR
Dec 8, 2025 at 8:53 PM#4
claudia_zurich 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.

This matches mine closely enough to be worth saying so out loud.

41 11sophie_paris, mel_PDX, Dr.AddMedPHL and 38 others
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traveltech_sara
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Jan 2025
Remote, USA
Dec 8, 2025 at 11:36 PM#5

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

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.

40 10BenResearch_OR, MikeKY_noInsulin, Dr.RaviCardio and 37 others
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