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ForumsMASH / Liver DiseaseLiver enzymes normal for the first time in a decade

Liver enzymes normal for the first time in a decade

BethLabQueen Thu, May 14, 2026 at 3:17 PM 22 replies 619 viewsPage 1 of 5
BethLabQueen
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May 14, 2026 at 3:17 PM#1

Fatty liver on an incidental scan two years ago and nobody followed it up. Now that I am losing weight I would like to know what to re-measure.

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.

Not looking for reassurance. Looking for the part I have got wrong.

1 21maya_sedona
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TrialTracker_MD
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May 14, 2026 at 3:27 PM#2
BethLabQueen said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 333 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 13 months: CAP dropped to 226 dB/m (minimal steatosis) and stiffness normalized to 5.3999999999999995 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.

50 20stefan_berlin, Dr.EM_Chicago, pete_RVA and 47 others
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newstart_MO
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May 14, 2026 at 3:37 PM#3
TrialTracker_MD said:
Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 333 dB/m (moderate steatosis) and stiffness 8.8 kPa (possible…

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.
49 19HPLC_Greg, LibrarianMeg, bri_stats and 46 others
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ricardo_MIA
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May 14, 2026 at 3:47 PM#4
BethLabQueen said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Second this.

48 18KetoKyle, CanadaChris, ZaraB_AL and 45 others
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julia.endo
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May 14, 2026 at 4:40 PM#5

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

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
ALT58257-56 U/L
AST612110-40 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.

47 17chris_chi24, tampaLisa73, KarenAZ_mom and 44 others
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