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Evidence-based GLP-1 & peptide discussion since 2023
ForumsMASH / Liver DiseaseNon-invasive MASH biomarkers — anyone have experience?

Non-invasive MASH biomarkers — anyone have experience?

dave_SLC Thu, Jan 15, 2026 at 10:26 PM 8 replies 872 viewsPage 1 of 2
dave_SLC
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Jan 15, 2026 at 10:26 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 narrow version of the question is whether normalised enzymes tell you anything about fibrosis, and what the right follow-up measurement is.

I have searched first, so if this is covered somewhere point me at it and I will read it.

40 10mike_mealprep, NicoleRaleigh, james_edin and 37 others
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JessicaH_TX
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Jan 15, 2026 at 10:33 PM#2
dave_SLC 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 10 months on GLP-1 therapy:

MarkerBaselineCurrentNormal Range
ALT57247-56 U/L
AST502610-40 U/L
GGT87389-48 U/L
ALP977944-147 U/L

FibroScan also improved — liver stiffness from 9.5 kPa to 5.2 kPa. The evidence for GLP-1 agonists in NAFLD/NASH is very promising.

Last edited: Jan 16, 2026 at 2:33 AM
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JennaRN
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Jan 15, 2026 at 10:40 PM#3
JessicaH_TX said:
Liver enzyme update related to liver and MASH: I had mildly elevated ALT/AST at baseline (likely NAFLD).

Liver imaging follow-up for liver and MASH: FibroScan at baseline showed CAP score 323 dB/m (moderate steatosis) and stiffness 10.8 kPa (possible fibrosis). Diagnosed with NAFLD.

After 15 months: CAP dropped to 226 dB/m (minimal steatosis) and stiffness normalized to 5.9 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.

Last edited: Jan 15, 2026 at 11:40 PM
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oliver_london
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Jan 15, 2026 at 10:47 PM#4
dave_SLC said:
Fatty liver on an incidental scan two years ago and nobody followed it up.

Can confirm. Same sequence, different timescale. I had assumed I was the exception until I read this.

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james_edin
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Jan 15, 2026 at 11:24 PM#5

From the other side of the consultation, briefly.

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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