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MASLD AI 01:34 AM
August 2025
Join Sarah Dawkins, NP, for quick and practical insights in this edition of GHAPP MASLD Community Network’s APP Insights. Sarah answers common questions from primary care providers about managing patients with hepatic steatosis on imaging but normal liver tests. She explains when to calculate a FIB-4 score, how to interpret mild ALT/AST abnormalities, and when referral to hepatology is necessary. Learn how to assess risk in patients with diabetes, obesity, or metabolic syndrome, and how to rule out other causes like viral hepatitis, alcohol use, drug-induced liver injury, and iron overload. Sarah emphasizes the importance of lifestyle counseling for low-risk patients and provides a clear framework for primary care providers to confidently monitor and manage MASLD without unnecessary referrals. A must-watch for anyone navigating the "gray zone" of liver diagnostics in everyday practice.
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Lifestyle Management With Whitney Steinmetz
July 2025
In this case-based clinical discussion, Whitney Steinmetz, FNP from Presbyterian Medical Group in Albuquerque, New Mexico, offers an in-depth review of lifestyle management strategies for patients with MASLD and MASH. Using the case of a 65-year-old male with persistently elevated ALT and metabolic syndrome, she highlights the importance of individualized, culturally competent counseling around nutrition, exercise, and behavioral change. Steinmetz outlines how tools like the FIB-4 score and FibroScan can help guide management and determine fibrosis risk, while emphasizing the critical role gastroenterology providers must play in addressing obesity, insulin resistance, and dietary habits. From the utility of motivational interviewing and realistic meal planning to the integration of caloric restriction and personalized exercise, this presentation equips clinicians with practical tools to support sustainable behavior change in patients with metabolic liver disease. Genetic factors, social determinants of health, and patient empowerment are all addressed, offering a holistic perspective on disease progression and prevention.
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MASLD vs MetALD With Kelly Smeester
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In this session from the GHAPP MASLD Community Network, Kelly Smeester, PA-C at South Denver Gastroenterology, reviews a patient case to highlight the overlap between metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic dysfunction plus alcohol-associated liver disease (MetALD). Using real-world labs, FibroScan values, CAP scores, and the PEth biomarker, she explains how clinicians can distinguish MASLD from MetALD and alcohol-related liver disease. The discussion covers key metabolic risk factors such as PCOS, hypertension, and hyperlipidemia, the impact of moderate alcohol intake, and how these drivers accelerate fibrosis progression and increase the risk of decompensation. Viewers will learn how to evaluate alcohol use through standardized definitions, clinical questionnaires, and biomarkers, as well as best practices for patient education, lifestyle counseling, and management, including diet, exercise, pharmacologic options, and hepatocellular carcinoma (HCC) surveillance. This case-based talk emphasizes why accurate diagnosis and objective assessment of alcohol consumption are essential for both clinical care and research in steatotic liver disease.
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In this practical, clinician-focused talk, Ellie Gonyeau, NP, walks through a streamlined pharmacotherapy framework for MASLD/MASH—anchored on three pillars: obesity management, cardiometabolic risk reduction (T2D, hypertension, dyslipidemia), and liver-directed therapy. She reviews where GLP-1 receptor agonists fit (weight loss, glycemic control, peri-procedure considerations), summarizes evidence and patient selection for high-dose vitamin E and pioglitazone, and explains the role of resmetirom—the first FDA-approved therapy for non-cirrhotic MASH with F2–F3 fibrosis—its liver-selective THR-β mechanism, pivotal trial outcomes, common AEs, and drug-interaction/ statin considerations. You’ll also learn how to monitor and restage using non-invasive tests (FibroScan kPa/CAP, ELF, labs), set measurable lifestyle goals, and navigate real-world questions around coverage, testing cadence, and treatment duration—so you can confidently tailor therapy and improve outcomes for patients across the MASLD/MASH spectrum.
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In this quick and practical episode, Allison Moser, a hepatology nurse practitioner at Rush University Medical Center in Chicago, answers three of the most common patient questions about metabolic dysfunction–associated steatohepatitis (MASH). She explains how MASH differs from MASLD (fatty liver disease without damage), why it develops in people who don’t drink alcohol, and how it can be reversed with lifestyle changes and new FDA-approved therapies. Allison highlights the link between MASH and metabolic syndrome conditions such as type 2 diabetes, obesity, high cholesterol, and hypertension, underscoring the importance of early identification and treatment. She also discusses the effectiveness of weight loss, dietary approaches like the Mediterranean diet, physical activity, and emerging pharmacologic therapies including resmetirom and semaglutide for patients with stage 2–3 fibrosis. Designed to keep the message simple and patient-centered, this video offers guidance for patients, families, and providers who want to better understand MASH, its risks, and how early action can reverse liver damage and prevent progression to cirrhosis.
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In this in-depth educational session, Lindsay Yoder, PA from Indiana University in Indianapolis, walks through two detailed case studies to highlight the differences between advanced F3 fibrosis and F4 cirrhosis. Using real-world clinical data—including labs, FibroScan, ELF testing, and imaging—she explains how to stage patients with MASLD/MASH, interpret non-invasive fibrosis assessments, and tailor treatment strategies. Viewers will learn how subtle differences in labs and imaging findings, such as thrombocytopenia and liver stiffness measurement, can shift a patient’s diagnosis from advanced fibrosis to cirrhosis. Lindsay also discusses the role of lifestyle interventions, multidisciplinary management, and therapeutic options like resmetirom and GLP-1s, as well as key monitoring strategies for hepatocellular carcinoma (HCC) surveillance and variceal screening. Whether you’re a hepatology provider, an APP, or a clinician looking to sharpen your skills in managing MASLD/MASH, this case-based discussion provides practical insights you can apply in everyday practice.
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Lifestyle Management With Sarah Dawkins
August 2025
Join Sarah Dawkins, NP, for an in-depth and inspiring conversation on lifestyle management for MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction-Associated Steatohepatitis), presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals. In this engaging session, Sarah uses the real-world case of "Albert" to explore how to assess fibrosis risk using non-invasive testing like FIB-4 and FibroScan, and why lifestyle interventions remain the cornerstone of care for patients without advanced fibrosis. Through a patient-centered lens, she outlines practical strategies for addressing dietary counseling, exercise goals, and culturally sensitive approaches to nutrition—highlighting how individualized care, family involvement, and positive reinforcement can create meaningful behavior change. The session dives into the science behind genetic risk factors like PNPLA3, the role of central obesity in inflammation, and the impact of Western diets on liver health. Sarah also reviews the Mediterranean diet, exercise recommendations, and evidence-based interventions, including the benefits of aerobic + resistance training over HIIT for MASLD improvement. With clinical pearls on motivational interviewing, overcoming barriers to access, and the use of tools like the Exercise and Diet Adherence Scale (EDAS), this session empowers providers to make lifestyle conversations impactful—even when time is short.
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Non-Invasive Testing With HoChong Gilles
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In this MASLD Community Network webcast, HoChong Gilles, NP, from the Central Virginia VA Health Care System, provides a comprehensive overview of the evolving role of non-invasive testing (NITs) in diagnosing and staging MASLD and MASH. Using a real-world case example, she demonstrates how tools such as FIB-4, ELF (Enhanced Liver Fibrosis) score, FibroScan (VCTE), MR Elastography, and ultrasound can help clinicians accurately stratify risk, detect significant fibrosis, and avoid unnecessary liver biopsies. HoChong explains the strengths, limitations, and quality considerations of each modality—highlighting how to interpret cut-offs, manage indeterminate results, and incorporate these tests into routine hepatology and GI practice. The session reinforces the importance of combining NIT results with metabolic risk factor management and underscores why accurate staging is essential as new therapies like resmetirom (Rezdiffra) become available for non-cirrhotic patients with F2–F3 fibrosis.
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