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MASLD AI 04:14 AM
January 2025
Thank you to Madrigal for sponsoring this FAQ Video Module.
In this GHAPP FAQ Video Module, Jonathan Yeh, a physician assistant at the Center for Liver Disease and Transplantation at Columbia University Irving Medical Center, discusses advancements in diagnosing and staging metabolic dysfunction-associated steatohepatitis (MASH). He explains the transition from traditional liver biopsy to non-invasive testing methods such as FibroScan and the Enhanced Liver Fibrosis (ELF) test for assessing fibrosis stages. Jonathan highlights the use of these methods, in combination with blood tests, to provide reliable staging of fibrosis in patients with MASH. For more information, visit the GHAPP website or ACE app.
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In this engaging episode from the GHAPP MASLD Community Network, Alison Moe shares practical insights into the most common questions patients ask about advanced fibrosis and fatty liver disease. Using a liver model, she explains the stages from normal liver to steatosis, fibrosis, and cirrhosis, emphasizing that with lifestyle modifications—such as weight loss, glycemic control, and now FDA-approved pharmacotherapy—fatty liver disease, including F3 fibrosis, can be reversible. Alison also addresses a critical concern: alcohol consumption. She breaks down how her guidance differs depending on the presence and stage of fibrosis, adhering to strict AASLD guidelines to protect liver health. Whether you're a healthcare provider or a patient looking for clarity, this video offers evidence-based guidance and compassionate answers.
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In this MASLD Community Network episode, Valerie Shin, NP with UCLA Health Hepatology, addresses frequently asked questions from community GI providers about noninvasive tests (NITs) for assessing steatosis and fibrosis in MASLD and MASH. She reviews the benefits and key limitations of the FIB-4 score—highlighting the risk of false negatives in patients with normal AST/ALT levels, false positives in older patients, and inaccuracy when thrombocytopenia is unrelated to liver disease. Valerie explains when to consider second-line NITs, including transient elastography (FibroScan®), ELF score, and MR elastography, detailing their strengths, availability challenges, and technical limitations such as operator dependence, BMI restrictions, and insurance coverage issues. She also clarifies the rare but important role of liver biopsy when NITs produce conflicting or inconclusive results. Whether you’re a healthcare provider seeking practical diagnostic guidance or a patient wanting to understand your testing options, this video offers expert insights into selecting and interpreting noninvasive liver tests for MASLD and MASH.
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Elizabeth Goacher, PA-C at Duke University in Durham, North Carolina, addresses a common misconception about Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)—that it’s a “death sentence.” While early screening and awareness are critical, Elizabeth emphasizes the importance of balanced messaging: most patients with MASLD, especially those without advanced fibrosis, will not experience liver failure or require a transplant. Instead, their greatest health risks are often from cardiovascular disease and all-cause malignancy, making lifestyle changes, metabolic health management, and cardiovascular risk reduction key priorities. This discussion encourages both patients and referring providers to focus on evidence-based care, clear communication, and realistic risk assessment, ensuring that awareness doesn’t translate into unnecessary fear.
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Common Questions From Patients About MASH
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