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ForumsMASH / Liver DiseaseHas anyone dealt with glp-1 hepatoprotection?

Has anyone dealt with glp-1 hepatoprotection?

GenomicsKate Fri, Jul 11, 2025 at 12:32 PM 33 replies 1,678 viewsPage 1 of 7
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GenomicsKate
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Jul 11, 2025 at 12:32 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.

The bit I cannot resolve on my own is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.

Numbers rather than impressions, if you have them.

42 12DebRD_ATL, KristenIndy, MarkLI_maint and 39 others
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MikeFit_NJ
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Jul 11, 2025 at 12:56 PM#2
GenomicsKate 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.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 327 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 13 months: CAP dropped to 240 dB/m (minimal steatosis) and stiffness normalized to 4.8 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.

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SaraMom3
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Jul 11, 2025 at 1:20 PM#3
MikeFit_NJ said:
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 327 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible…

Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD). After 7 months on GLP-1 therapy:

MarkerBaselineCurrentNormal Range
ALT78257-56 U/L
AST612510-40 U/L
GGT78299-48 U/L
ALP1088544-147 U/L

FibroScan also improved — liver stiffness from 9.5 kPa to 6.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

Last edited: Jul 11, 2025 at 5:20 PM
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maria_elpaso
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Jul 11, 2025 at 1:44 PM#4
GenomicsKate 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.

Second this.

Last edited: Jul 11, 2025 at 7:44 PM
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chris_chi24
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Jul 11, 2025 at 3:57 PM#5

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

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: Jul 11, 2025 at 6:57 PM
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