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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMASH / Liver DiseaseHas anyone dealt with non-invasive mash biomarkers?

Has anyone dealt with non-invasive mash biomarkers?

quinn_sf Thu, Apr 30, 2026 at 2:16 PM 14 replies 668 viewsPage 1 of 3
quinn_sf
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Jun 2024
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Apr 30, 2026 at 2:16 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 question I want answered is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.

Tell me what I have not thought of.

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Dr.PainCLE
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Cleveland, OH
Apr 30, 2026 at 2:21 PM#2
quinn_sf 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.
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wendy_avl
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Apr 30, 2026 at 2:26 PM#3
Dr.PainCLE 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 7 months on GLP-1 therapy:

MarkerBaselineCurrentNormal Range
ALT62297-56 U/L
AST652110-40 U/L
GGT72299-48 U/L
ALP1127944-147 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: Apr 30, 2026 at 8:26 PM
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tampaLisa73
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Apr 30, 2026 at 2:31 PM#4
quinn_sf 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.

Same pattern here, and in the same order. Nothing to add that would improve it.

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PeptideChemSF
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Apr 30, 2026 at 2:57 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.

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