Hepatic steatosis grading on ultrasound — 6 month update

amsterdam_pete said:

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 341 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible…

NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy. The Phase 2b data for semaglutide showed 59% NASH resolution (vs 17% placebo) with 43% achieving fibrosis improvement[1].

Mechanism: GLP-1R activation reduces hepatic lipogenesis, increases fatty acid oxidation, reduces hepatic inflammation, and may directly reduce hepatic stellate cell activation (fibrosis pathway).

With resmetirom (thyroid hormone receptor agonist) recently approved for NASH, the field is evolving rapidly. Combination approaches (GLP-1 + resmetirom) are being explored.

pete_manc_UK 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 11 months on GLP-1 therapy:

FibroScan also improved — liver stiffness from 10.5 kPa to 6.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

TrialTracker_MD said:

NASH/MAFLD therapeutic landscape and liver and MASH: GLP-1 agonists are emerging as potential first-line NASH therapy.

Adding the part of the answer the thread has not reached. There is a difference between no evidence and evidence of no effect, and this subject is one where the two get swapped freely in both directions.

Following on from roxy_nash — and this may be the naive question:

How would you tell the difference between that and the alternative explanation?

Closing the loop on my own question.

Update — I was wrong in the opening post, specifically about the direction. Correcting it here rather than editing it away.