Has anyone dealt with mash biomarker panel?

This one has a reasonably settled answer, so here it is. A defensible baseline is short: HbA1c and fasting glucose, a lipid panel with ApoB if you can get it, ALT and AST, creatinine with eGFR, TSH, ferritin and B12, and a full blood count. That set catches the things that change, the things that explain symptoms, and the things that alter the prescribing decision. Almost everything else on the long circulating lists is either invariant, uninterpretable without a specific question, or an incidental finding waiting to cause an unnecessary workup.

Dr.CardioMD said:

A defensible baseline is short: HbA1c and fasting glucose, a lipid panel with ApoB if you can get it, ALT and AST, creatinine with eGFR, TSH, ferritin…

Agreed, and reference ranges are laboratory-specific. Comparing your number to somebody else's range, or to a screenshot from another country, is how people convince themselves something is wrong.

Dr.ObesityMed said:

Fatty liver on an incidental scan two years ago and nobody followed it up.

Can confirm the pattern Dr.ObesityMed describes. One addition: if the lab changes analytical platform between your draws, the comparison breaks and nobody tells you. It is worth asking when a value moves inexplicably.

That is the short version; the long version is somebody else's post.

Clinical perspective, offered as context rather than as advice.

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:

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.