Chat with MASLD AI
Hi, I am MASLD AI.
Suggested Questions :
MASLD AI 08:24 PM
September 2025
Welcome to the MASLD Community Network, where experts share practical insights on diagnosing and managing metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic dysfunction–associated steatohepatitis (MASH). In this session, Janet Gripshover, NP and Nurse Manager of the Liver Transplant Program at Cedars-Sinai, explores one of the most challenging aspects of hepatology—distinguishing between F3 fibrosis and F4 cirrhosis. She explains why identifying the transition from bridging fibrosis to cirrhosis is critical for patient outcomes, treatment decisions, and cancer surveillance. Using real-world case discussions, Janet reviews non-invasive diagnostic tools such as FIB-4, transient elastography (FibroScan®), ELF testing, and lab findings, highlighting how concordant results strengthen diagnostic confidence. She also addresses risk factors like obesity, type 2 diabetes, hypertension, and sleep apnea, and emphasizes the role of lifestyle modification, GLP-1 therapies, and new treatments that can reduce fat and fibrosis progression. Importantly, she discusses why cirrhosis shifts management priorities from prevention to preservation and underscores the need for hepatocellular carcinoma (HCC) surveillance. Whether you are a hepatology provider, APP, or clinician looking to better understand the nuances of staging MASLD/MASH, this video provides a comprehensive and practical guide to diagnosing and managing advanced liver fibrosis.
Related Podcast
MASLD vs MetALD With Elizabeth Goacher
September 2025
Elizabeth Goacher, PA-C, explains MASLD vs MetALD within the broader Steatotic Liver Disease (SLD) spectrum—and why separating metabolic dysfunction alone (MASLD) from metabolic dysfunction + alcohol exposure (MetALD) changes risk stratification and management. Through a real case, Elizabeth shows how to assess fibrosis risk, interpret CAP/Liver Stiffness, and recognize factors that can inflate stiffness. She reviews practical alcohol quantification, the limits of self-report, and when an objective biomarker like PEth can clarify true exposure—especially for patients with borderline metabolic criteria (e.g., isolated hypertension or hypertriglyceridemia). You’ll learn a stepwise approach for: confirming SLD etiology (exclude DILI, viral hepatitis, monogenic disease), choosing FIB-4, VCTE/FibroScan, or ELF for secondary assessment, deciding when to refer or biopsy for discordant results, and prioritizing therapy (alcohol reduction/cessation, cardiometabolic risk control, lifestyle intervention, and when targeted MASLD pharmacotherapy may be appropriate). She also discusses progression risk (MetALD accelerates vs MASLD), and thoughtful use of HCC surveillance in higher-risk patients. Perfect for APPs, GI/hepatology clinicians, and primary care optimizing real-world MASLD/MetALD care.
Watch Now
Discordant NITs: The Gray Zone
August 2025
Join Melissa Franco, PA at the University of Miami, for an in-depth episode of the GHAPP MASLD Community Network podcast focused on discordant non-invasive tests (NITs) and navigating the "gray zone" of liver fibrosis staging. Melissa walks through common real-world scenarios where FIB-4, FibroScan, ultrasound, ELF score, and MR elastography deliver conflicting results—exploring why this happens and how to approach it clinically. Learn how patient factors such as obesity, alcohol use, co-morbidities, medications, and test limitations can impact NIT interpretation. Discover Melissa’s expert strategies for re-evaluating results, when to consider liver biopsy, and how to communicate these complexities with patients. From understanding how false elevations occur to using imaging and labs to confirm or exclude advanced fibrosis, this episode provides a practical and evidence-based approach to staging MASLD and MASH when results don’t align. Whether you're managing metabolic liver disease in hepatology or primary care, this is essential listening for interpreting liver diagnostics in nuanced clinical settings.
Watch Now
Practical Techniques for Lifestyle Adherence
July 2025
In this episode, Emily Przybyl, PA-C at Erie County Medical Center in Buffalo, NY, dives into the foundations of motivational interviewing for patients with MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH. With practical, real-world insights from her clinical experience, Emily shares how providers can build trust, meet patients where they are, and guide them toward meaningful, sustainable lifestyle changes. She emphasizes asking open-ended questions, assessing social determinants of health like income and food access, and collaboratively developing realistic diet and exercise plans tailored to each patient’s circumstances. Emily also highlights culturally sensitive counseling techniques, strategies for overcoming barriers like limited mobility or unsafe environments, and the importance of setting SMART goals for weight loss and liver health. Whether patients are struggling with motivation, resistant to change, or unsure where to start, this episode provides a supportive, patient-centered framework for fostering long-term behavior change in metabolic liver disease.
Watch Now
LFTs Demystified: A Practical Guide for APPs
August 2025
Join Maly Tiev, NP at NYU Langone Health, for this essential educational session on demystifying liver function tests (LFTs), brought to you by the GHAPP MASLD Community Network. In this video, Maly explains how to interpret ALT, AST, alkaline phosphatase, GGT, bilirubin, albumin, INR, and platelet counts in the context of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis). Learn why elevated liver enzymes are not always present in MASH, how to distinguish between different causes of abnormal LFTs—including alcohol-related liver disease, viral hepatitis, and drug-induced liver injury—and how serial LFT monitoring can indicate treatment response or disease progression. Discover the importance of using non-invasive tools for fibrosis risk stratification, the role of platelets as a key marker, and how a deeper understanding of synthetic function tests can help identify cirrhosis earlier. Whether you're a clinician or a patient looking to understand the lab work behind fatty liver disease, this presentation offers practical insights for interpreting LFTs with confidence.
Watch Now
Non-Invasive Testing With Brian Lam
August 2025
Join Brian Lam, PA-C, Associate Medical Director of Research at Inova’s Liver and Obesity Research Program and Chair of the Global NASH/MASH Council’s PA Committee, for a masterclass on non-invasive testing (NITs) in the evaluation of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH, presented through the GHAPP MASLD/MASH Community Network and sponsored by Madrigal Pharmaceuticals. In this dynamic and case-based session, Brian outlines a practical, step-by-step approach to identifying patients at risk for advanced fibrosis, using tools like FIB-4, ELF, FibroScan (VCTE), and MR Elastography. He walks through the critical cutoffs, diagnostic performance, limitations, and how to interpret imaging and lab-based scores in real-world hepatology and primary care settings. You'll learn how to apply AGA and AASLD clinical algorithms, the importance of staging patients with diabetes and metabolic syndrome, and how to distinguish low-risk MASLD from at-risk MASH. Brian also shares best practices for TE reliability, quality control, and using NIT combinations like FAST, MAST, and MEFIB for accurate diagnosis. With clear visuals, expert insights, and actionable takeaways, this session is an essential update for APPs, GI, hepatology, and primary care providers managing fatty liver disease in 2025 and beyond.
Watch Now
Common Questions from Patients About MASH
July 2025
In this focused episode, Suzanne Robertazzi, NP at the Washington DC VA, shares expert insights on how to prevent recurrence of MASH (Metabolic-associated steatohepatitis) and MASLD (Metabolic dysfunction-associated steatotic liver disease) in liver transplant recipients. Drawing on her experience caring for post-transplant veterans, Suzanne explains that MASH can return even after liver transplantation, making ongoing metabolic management essential. She outlines key strategies including tight blood sugar and blood pressure control, especially since transplant medications can contribute to hypertension. Suzanne also emphasizes the importance of introducing regular physical activity post-recovery and adopting a Mediterranean-style diet—while tailoring nutrition guidance to meet the needs of patients in urban settings with limited access to fresh foods. This video is a must-watch for transplant teams, hepatology providers, and patients seeking to extend the life and health of their new liver through evidence-based lifestyle and clinical interventions.
Watch Now
MASLD Pharmacotherapy With Patrick Horne
September 2025
Join Patrick Horne, NP for a clear, clinic-ready overview of MASLD/MASH pharmacology—from the lifestyle backbone to cardiometabolic risk reduction and liver-directed therapies. Patrick breaks down where GLP-1 receptor agonists fit, reviews evidence and patient selection for vitamin E and pioglitazone, and spotlights resmetirom—the first FDA-approved THR-β agonist for non-cirrhotic MASH with F2–F3 fibrosis—including mechanism, key MAESTRO-NASH outcomes, common AEs (nausea/diarrhea), and practical drug–drug interactions. Walk away with a step-by-step approach to selecting therapy, setting measurable lifestyle goals, and using NITs to monitor response and guide duration—so you can confidently tailor treatment and improve outcomes.
Watch Now
Common Questions From Community GI About MASH
July 2025
In this session, Lavinia Iordache, PA-C, from the University of Miami, draws on a decade of experience in inpatient and outpatient hepatology to address common management questions related to MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis). She provides practical guidance for gastroenterology providers navigating when to monitor versus refer patients with fibrosis, how to interpret and time non-invasive testing (NITs) such as FIB-4, and when liver biopsy may still play a role—particularly in cases with persistently elevated liver enzymes despite lifestyle improvement. Lavinia also dives into the referral criteria for hepatology, the evolving role of resmetirom in stage 2–3 fibrosis, and the critical topic of HCC screening. While current AASLD guidelines limit HCC surveillance to cirrhosis, Lavinia highlights emerging evidence and EASL recommendations supporting imaging in patients with F3 fibrosis based on individualized risk factors like diabetes, genetics, and obesity. She also explains why CT or MRI is often preferred over ultrasound in MASLD patients due to obesity-related imaging limitations. This is a must-watch for hepatology and GI teams managing liver fibrosis in metabolic disease.
Watch Now
Common Questions From Patients About MASH
July 2025
In this practical and patient-focused discussion from the GHAPP MASLD/MASH Community Network, we address some of the most frequently asked questions by patients newly diagnosed with MASLD (Metabolic dysfunction-associated steatotic liver disease). Many patients wonder how they can have liver disease if they don’t drink alcohol. This video explains the evolution from NAFLD to MASLD, emphasizing that MASLD is rooted in metabolic risk factors—not alcohol use—and commonly affects individuals with diabetes, obesity, and hypertension. Viewers will also learn about evidence-based lifestyle interventions, including the benefits of a hypocaloric diet, the recommended Mediterranean-style eating pattern, and 150 minutes of weekly physical activity. Finally, we tackle the question “Is MASLD curable?” with empowering guidance on how weight loss and exercise can help reverse liver damage and reduce liver fat. This is a must-watch for clinicians, care teams, and patients seeking clarity and confidence in managing this increasingly common liver disease.
Watch Now
MASLD Pharmacotherapy With Jonathan Yeh
August 2025
In this GHAPP MASLD Community Network Education Series, Jonathan Yeh, PA from Columbia University Irving Medical Center, reviews the latest advances in pharmacotherapy for MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). This presentation explores the evolution from NAFLD to MASLD, highlighting why metabolic dysfunction is central to disease progression. Jonathan discusses the role of lifestyle modification, GLP-1 receptor agonists (such as semaglutide and tirzepatide), vitamin E, pioglitazone, and bariatric surgery, while focusing on resmetirom—the first FDA-approved therapy for adults with non-cirrhotic MASH and moderate to advanced fibrosis. The session explains how resmetirom works as a thyroid hormone receptor beta agonist, its clinical trial evidence from the MAESTRO-NASH study, patient eligibility, safety considerations, drug–drug interactions, and monitoring recommendations. With ongoing studies and expanding treatment options, this discussion provides clinicians with practical strategies for managing MASLD and MASH, improving liver outcomes, and addressing the challenges of insurance access and long-term therapy.
Watch Now