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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.
Related Podcast
MASH/MASLD in Type 2 Diabetes: Concurrent Medication Management
August 2025
In this video, April Morris, FNP, shares her expertise on the close connection between type 2 diabetes and fatty liver disease (MASLD/MASH). With over 16 years of experience in hepatology and endocrinology, she explains why patients with type 2 diabetes are at a higher risk of developing MASH due to shared risk factors like insulin resistance and obesity. April highlights how improving glycemic control, lowering A1C, weight loss, and lifestyle modifications can significantly reduce liver fat, inflammation, and fibrosis progression. She discusses the benefits of modern diabetes medications—including GLP-1 receptor agonists such as semaglutide and tirzepatide, SGLT2 inhibitors, and metformin—and how they not only improve blood sugar and weight management but also support liver, kidney, and heart health. Importantly, she notes that most diabetes medications remain safe for patients with liver disease unless advanced decompensated cirrhosis is present, where caution with metformin may be necessary due to lactic acidosis risk. April emphasizes that treating diabetes aggressively and reaching an A1C target around 7% can slow or even prevent progression of liver fibrosis. For APPs and providers, the takeaway is clear: effective diabetes management is one of the most powerful tools to improve liver outcomes.
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Podcast: Pharmacotherapy for MASH/MASLD: An Overview
June 2025
In this informative episode, Lindsay Yoder, PA, a hepatology expert at Indiana University, provides a comprehensive overview of current pharmacotherapy options for MASH (Metabolic Dysfunction–Associated Steatohepatitis), focusing on the first FDA-approved medication, resmetirom (brand name: Rezdiffra). Speaking directly to the MASLD/MASH Community Network, Lindsay breaks down the key histologic endpoints that led to resmetirom’s conditional approval—namely, fibrosis improvement without worsening of steatohepatitis, and MASH resolution without worsening fibrosis. She shares real-world data from clinical trials showing that resmetirom nearly doubles the rate of fibrosis improvement and triples MASH resolution compared to placebo. Lindsay also explains how the drug works: as a thyroid hormone receptor beta agonist, resmetirom improves hepatic lipid metabolism, reduces liver fat, and dampens inflammation—all key drivers of MASH progression. She outlines ideal patient criteria (stage F2–F3 fibrosis without cirrhosis), safety considerations, tolerability, potential side effects, and statin interactions. With an emphasis on combining pharmacotherapy with lifestyle changes, this episode serves as a practical guide for clinicians treating patients with MASH who qualify for advanced intervention.
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APP Insight: Misconceptions About Liver Health
June 2025
In this video, Kelly Smeester, PA-C from South Denver Gastroenterology, addresses some of the most common and harmful misconceptions about liver health. One major myth she tackles is the belief that liver disease only affects those who drink excessive amounts of alcohol. Kelly explains that liver disease has many causes—including autoimmune conditions, viral infections, and metabolic dysfunction—meaning even individuals who don’t drink at all may still be at risk. She emphasizes the dangers of relying on unregulated “liver detox” supplements, clarifying that the liver is a natural detox organ and doesn’t require external cleanses, which may actually do more harm than good. Kelly also highlights how liver disease can be entirely asymptomatic, particularly in patients with conditions like type 2 diabetes, obesity, hypertension, and high cholesterol. Finally, she reinforces that cirrhosis is not solely alcohol-related and can result from steatotic liver disease, making regular liver evaluations and screenings crucial for early detection and management. This video is an essential resource for patients and providers aiming to better understand liver health beyond outdated myths.
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Serological Workup: A Step-by-Step Guide
July 2025
In this comprehensive video, Sherona Bau, NP from UCLA, breaks down the essential hepatology workup for patients with MASLD (formerly NAFLD) and MASH, offering guidance for both primary care providers and GI/hepatology specialists. Drawing from her extensive clinical experience, she outlines a systematic approach to evaluating abnormal liver ultrasound findings—starting with critical labs to rule out chronic liver conditions like hepatitis B, hepatitis C, autoimmune hepatitis, PBC, and hereditary hemochromatosis. Sherona discusses the importance of ordering ANA, AMA, ferritin, serologies, and even specialized labs like the phosphatidylethanol (PEth) test to uncover alcohol-related liver disease that may be overlooked. She emphasizes the need to screen for cardiometabolic risk factors including type 2 diabetes and dyslipidemia and highlights non-invasive tests such as FibroScan and FIB-4 to help identify patients at risk of advanced fibrosis who may benefit from specialist referral. Most importantly, Sherona addresses the fears many patients face around liver disease progression and life expectancy, encouraging early intervention and coordinated care to improve long-term outcomes. This video is a must-watch for any clinician managing steatotic liver disease.
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Comparing F3 and F4 Fibrosis With Lavinia Iordache
September 2025
In this MASLD Community Network talk, Lavinia Iordache, PA, walks through a real-world case to show how to accurately identify advanced liver fibrosis and, critically, how to distinguish F3 vs F4—a difference that drives management, eligibility for resmetirom (Rezdiffra), and surveillance strategy. She demonstrates a stepwise use of non-invasive tests (NITs)—FIB-4, FibroScan/VCTE with kPa and CAP, ELF serum biomarkers, and when to add MRE or biopsy—plus how to handle discordant/indeterminate results. The session covers cardiometabolic risk factors, lab patterns, and practical monitoring tips, including HCC surveillance considerations (modality choice in obesity, AFP/AFP-L3) and portal-hypertension cues that trigger EGD for varices. You’ll leave with a clear algorithm to stage disease, personalize treatment, and avoid missing F3 candidates who may otherwise be excluded by FIB-4 alone.
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Discordant NITs, the Gray Zone
July 2025
Join Lindsay Pratt, PA-C, from the University of Colorado School of Medicine’s Hepatology and Liver Transplant Department, as she unpacks the challenges of interpreting discordant results between non-invasive liver testing tools such as FIB-4 and FibroScan in patients with MASLD and MASH. With over 15 years of clinical experience, Lindsay walks viewers through how age, transaminase levels, platelet count, and patient factors like BMI and fasting status can impact test accuracy and reliability. She emphasizes when to consider advanced diagnostics like MRI elastography (MRE) or liver biopsy, and how to tailor decisions to the individual patient, especially when results don't align. This practical session is ideal for hepatology and GI providers navigating complex liver disease management, and includes tips for communicating test limitations and next steps with patients. Learn how to make informed decisions using non-invasive tests while maintaining patient-centered care in the management of fatty liver disease.
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Common Questions From Primary Care Providers About MASH With Allison Moser
September 2025
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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Non-Invasive Testing With Sherona Bau
July 2025
In this engaging and highly informative GHAPP MASLD Community Network session, Sherona Bau, PA-C, walks attendees through a practical overview of non-invasive testing (NIT) for evaluating liver health in patients with MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Drawing on real-world clinical experience, Sherona explains why non-invasive testing is essential for identifying fibrosis risk in a population where liver steatosis is prevalent in up to 30% of U.S. adults. Through the case of a 65-year-old Hispanic male named Albert, Sherona demonstrates how to interpret and apply tools such as FIB-4, FibroScan (VCTE and CAP score), ELF (Enhanced Liver Fibrosis) test, and MR Elastography (MRE). She highlights their respective strengths, limitations, clinical cut-offs, and insurance-related considerations. The session also covers when to order tests, how to assess data quality (e.g., IQR/median ratio in VCTE), and when to escalate care to hepatology or cardiology. Whether you are a primary care provider, endocrinologist, or hepatology specialist, this talk delivers practical algorithms and decision-making pathways for managing MASLD, improving early detection of fibrosis and cirrhosis, and integrating cardiovascular risk assessment into liver care. Sherona also emphasizes the importance of alcohol use history, metabolic syndrome risk factors, and annual NIT follow-up in patients at risk for disease progression.
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MASLD Pharmacotherapy With Whitney Steinmetz
August 2025
Join Whitney Steinmetz, NP, from Presbyterian Medical Group in Albuquerque, NM, for an in-depth review of pharmacotherapy in MASLD and MASH, presented as part of the GHAPP MASLD Community Network. In this comprehensive CME-eligible session, Whitney explores the multimodal treatment approach for patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH), focusing on three therapeutic pillars: obesity management, cardiometabolic risk reduction, and liver-directed therapies. The discussion covers mechanisms, clinical trial data, and practical considerations for key treatment options, including GLP-1 receptor agonists, vitamin E, pioglitazone, and resmetirom (Rezdiffra). Whitney highlights findings from landmark studies such as ESSENCE, PIVENS, and MAESTRO-NASH, and explains how thyroid hormone receptor beta activation through resmetirom reduces hepatic fat, inflammation, and fibrosis in F2-F3 patients. She also offers guidance on non-invasive monitoring (FibroScan, MRE, ALT), drug–drug interactions, and how evolving guidelines from AASLD and ESLD shape clinical decision-making. Whether you're treating early-stage fatty liver disease or managing moderate fibrosis in primary care or hepatology, this video provides evidence-based insights to optimize long-term outcomes through targeted pharmacologic strategies and patient-centered care.
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PCP Screening for MASH/MASLD: Identifying At-Risk Patients
July 2025
In this essential FAQ video, Jennifer Geremia, PA-C, a seasoned gastroenterology provider practicing in Boston, outlines current primary care screening guidelines for identifying patients at risk for metabolic dysfunction-associated steatohepatitis (MASH) and MASLD. With nearly two decades of experience caring for GI and liver patients, Jennifer emphasizes the importance of integrating liver health into routine health maintenance—particularly for individuals with type 2 diabetes, obesity, metabolic syndrome, and related conditions. She reviews practical steps for risk stratification, beginning with FIB-4 scoring using readily available labs, and discusses how to interpret and act on the results, including when to refer for further testing like elastography or ELF testing. Viewers will also gain insight into patient counseling strategies, alcohol intake guidance, and the urgency of acting early—even in asymptomatic patients. This video is a must-watch for primary care clinicians aiming to improve detection and management of MASH and MASLD through evidence-based screening and timely intervention.
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