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MASLD AI 01:35 AM
August 2025
Join Alison Moe, PA-C, from Atlanta Gastroenterology Associates, as she walks through a real-world clinical case highlighting the challenges and strategies in managing Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH). In this engaging and educational session, Alison shares the case of a 65-year-old Hispanic male with obesity, type 2 diabetes, and fatty liver disease—diving deep into non-invasive diagnostic tools, including FIB-4 scoring and FibroScan, and how these help guide risk stratification for liver fibrosis. The discussion emphasizes the crucial role of dietary counseling, culturally sensitive lifestyle modifications, and exercise guidance to slow or even reverse disease progression. Learn how to set achievable goals for patients and explore effective methods for improving glycemic control, BMI, and overall liver health. Alison also touches on evidence-based interventions such as the Mediterranean diet, resistance training, and intermittent fasting, supported by AASLD and European liver guidelines. Whether you're a clinician treating MASLD or simply interested in the evolving approach to fatty liver disease, this case study offers practical takeaways and guidance to optimize patient outcomes.
Related Podcast
MASLD Pharmacotherapy With Christina Hanson
September 2025
Learn about the latest advances in MASLD and MASH pharmacotherapy in this educational session from the GHAPP MASLD Community Network. Christina Hanson, NP, reviews the evolving landscape of treatment for metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH), including the critical role of weight loss, cardiovascular risk reduction, and liver-directed therapies. The discussion covers current management strategies such as GLP-1 receptor agonists, bariatric interventions, statins, and lifestyle modification, while also exploring guideline-supported options like vitamin E and pioglitazone. Special attention is given to the first FDA-approved therapy for MASH, Resmetirom, including its mechanism, clinical trial results, safety considerations, and monitoring recommendations. Whether you are a hepatology specialist, primary care provider, endocrinologist, or advanced practice provider, this session highlights practical approaches to managing patients with MASLD and MASH and offers insights into emerging therapies that may shape future clinical practice.
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MASLD Basics With Melissa Franco
August 2025
Join Melissa Franco, PA-C, from the University of Miami for a comprehensive review of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and the 2023 nomenclature updates replacing NAFLD and NASH. Presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals, this session covers the spectrum of steatotic liver disease, including MASLD, MASH, MetALD, alcohol-related liver disease (ALD), and other causes of hepatic steatosis. Learn how to diagnose MASLD using imaging, cardiometabolic risk criteria, and how to exclude other causes like alcohol use, medications, and genetic disorders. Melissa explains how to risk stratify patients using FIB-4, FibroScan, and ELF testing, and when to consider referral to hepatology, especially for patients at intermediate or high risk for advanced fibrosis. The talk also explores global prevalence, natural history, disease progression to cirrhosis and HCC, and highlights the importance of identifying and managing patients with F2–F4 fibrosis, now classified as at-risk MASH. Through a real-world case study, viewers are guided on how to perform a thorough MASLD workup and assess patients for pharmacotherapy, lifestyle counseling, and surveillance protocols. Whether you are in primary care, GI, or endocrinology, this session is an essential resource for early diagnosis and comprehensive management of fatty liver disease in today’s clinical practice.
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APP Insight: Common Questions from Patients About MASH
June 2025
In this episode, Jordan Mayberry, MPAS, PA-C, a seasoned hepatology provider at UT Southwestern in Dallas, Texas, addresses some of the most frequently asked questions from patients diagnosed with MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). With over 12 years of clinical experience, Jordan explains the root causes of MASLD/MASH, including key cardiometabolic risk factors like obesity, diabetes, hypertension, and hyperlipidemia, as well as genetic predispositions—particularly in Hispanic populations. He emphasizes the importance of fibrosis assessment in guiding treatment decisions, explaining that patients with early-stage disease should focus on lifestyle changes, while those with more advanced fibrosis (stages F2–F3) may be candidates for pharmacologic therapy such as resmetirom (Rezdiffra). Jordan also explores how prognosis depends on fibrosis stage and long-term management of comorbidities, making early intervention and risk stratification essential. This episode offers practical insights for clinicians aiming to improve conversations and care strategies for patients living with MASLD or MASH.
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Non-Invasive Testing With April Morris
July 2025
In this educational presentation, April Morris, FNP—an experienced provider in both liver disease and endocrinology—guides viewers through the evolving landscape of non-invasive testing (NITs) for diagnosing and managing patients with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH. Using the case of a 65-year-old male with metabolic co-morbidities and suspected liver disease, Morris reviews how to effectively apply tools like the FIB-4 score, ELF test, and FibroScan (VCTE) to assess fibrosis risk and stratify patients. She compares imaging modalities including transient elastography, MR elastography (MRE), and shear wave elastography, offering practical considerations such as patient eligibility, test accuracy, and insurance barriers. The discussion emphasizes the importance of interpreting NITs within clinical context—highlighting how to determine risk, guide patient counseling, and establish a follow-up plan for low-risk patients. This session also reinforces the role of primary care in longitudinal liver health management and directs providers to resources available through the GHAPP MASLD & MASH Community Network.
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MASLD vs MetALD With Jennifer Geremia
September 2025
In this GHAPP MASLD Community Network presentation, Jennifer Geremia, PA-C explains how to differentiate metabolic dysfunction–associated steatotic liver disease (MASLD) from metabolic dysfunction plus alcohol-associated liver disease (MetALD) and how to manage patients who sit on the MASLD–MetALD spectrum. Using a classic case (52-year-old with BMI 29.4, PCOS, hypertension, hyperlipidemia, ultrasound-confirmed steatosis, FibroScan 11.4 kPa [F3] and CAP 310), she shows how to combine history, “standard drink” counseling, AUDIT-C screening, and objective biomarkers like PEth to uncover under-reported alcohol use, quantify grams/day or week, and classify risk. You’ll learn practical algorithms for ruling out alternative etiologies, assessing cardiometabolic drivers, interpreting noninvasive tests, and estimating 5-year decompensation risk across MASLD, MetALD, and ALD. The session closes with actionable care steps: lifestyle and Mediterranean-style nutrition, exercise and weight-loss targets, strict alcohol cessation (and referral when appropriate), consideration of pharmacologic options in advanced fibrosis, and when to initiate HCC surveillance. Scan the QR code to confirm attendance and access more MASLD/MetALD education and resources.
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Misconceptions About Liver Health
July 2025
In this quick myth-busting session, Elizabeth Alqueza, PA-C from Beth Israel Deaconess Medical Center in Boston, addresses two of the most common misconceptions in hepatology related to steatotic liver disease (MASLD/MASH). First, she explains that liver disease is not always fixed or irreversible—and with proper management and elimination of the underlying cause, liver fibrosis can improve over time, a trend often monitored through FibroScan®. Second, she clarifies that significant liver improvement does not require extreme weight loss. In fact, a modest 5–10% reduction in total body weight—sometimes as little as 10–20 pounds—can lead to measurable improvements in liver inflammation and fibrosis. This video is ideal for providers and patients seeking a clearer understanding of how lifestyle changes can reverse liver disease and why timely, targeted interventions matter.
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MASLD Pharmacotherapy With Jeremy Davis
September 2025
In this clinician-focused talk, Jeremy Davis, NP, delivers a clear, practical guide to MASLD/MASH pharmacotherapy—from foundational lifestyle and weight-loss strategies to medications that move the needle. He reviews the role of GLP-1 receptor agonists (and emerging dual agonists) for weight reduction and glycemic control, peri-procedure considerations (delayed gastric emptying/aspiration risk), and where legacy options like vitamin E (select non-diabetic, non-cirrhotic patients) and pioglitazone fit, including benefits and safety trade-offs. The session spotlights resmetirom—the first FDA-approved, liver-directed THR-β agonist for non-cirrhotic MASH with F2–F3 fibrosis—covering its mechanism, key MAESTRO-NASH data, common AEs (nausea/diarrhea), and practical drug–drug interaction/statin-dosing considerations. You’ll also learn how to structure follow-up with non-invasive testing (FibroScan kPa/CAP, ELF, labs), set measurable lifestyle goals, coordinate cardiometabolic risk reduction (T2D, hypertension, dyslipidemia), and navigate coverage and duration questions—so you can confidently tailor therapy and improve outcomes across the MASLD/MASH spectrum.
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MASLD vs MetALD With Patrick Horne
September 2025
In this case-based session from the GHAPP MASLD Community Network, Patrick Horne, NP explains how to differentiate metabolic dysfunction–associated steatotic liver disease (MASLD) from metabolic dysfunction plus alcohol-associated liver disease (MetALD). Through the story of a 52-year-old patient with F3 fibrosis and severe steatosis, he reviews the modern SLD framework, metabolic risk factors (e.g., BMI, PCOS, hypertension, hyperlipidemia), and how alcohol intake interacts with insulin resistance, the gut microbiome, and hepatic lipid handling to accelerate inflammation and fibrosis. Patrick demonstrates practical tools—clear “standard drink” counseling, thorough history, AUDIT-C screening, and objective biomarkers like PEth—to uncover under-reported alcohol use and classify patients on the MASLD–MetALD–ALD spectrum. Management takeaways include Mediterranean-style nutrition, exercise and weight-loss targets, consideration of pharmacologic options in advanced fibrosis, firm guidance on alcohol cessation, and nuanced discussion of HCC surveillance in F3 disease. Ideal for APPs and hepatology clinicians, this talk delivers actionable algorithms, definitions, and trial-readiness considerations to standardize MetALD assessment and improve outcomes in steatotic liver disease.
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Common Questions From Primary Care Providers About MASH
August 2025
In this MASLD and MASH Community Network, Tessa Janovsky, PA-C at Arizona Liver Health, answers common questions from primary care providers about Metabolic Dysfunction–Associated Steatohepatitis (MASH) and its updated terminology. She explains why MASH has replaced the term NASH, highlighting the shift to reflect underlying metabolic drivers such as obesity and type 2 diabetes while removing stigmatizing language. Tessa discusses how normal or mildly elevated liver enzymes do not rule out MASH, the importance of screening high-risk groups—including patients with diabetes, obesity, metabolic syndrome, or incidental fatty liver on imaging—and why the FIB-4 score is the preferred first-line test for fibrosis risk assessment. She also reviews the first FDA-approved medication for MASH, resmetirom, as well as the role of GLP-1 therapies and upcoming treatment options. Whether you’re a clinician seeking updated screening guidelines or a patient wanting clarity on diagnosis and management, this session provides clear, evidence-based guidance on identifying and treating MASH.
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Non-Invasive Testing With Maly Tiev
September 2025
Maly Tiev, NP, NYU Langone Health, shares a practical, case-based walkthrough of non-invasive testing (NITs) for MASLD/MASH—showing how to move from initial risk identification to confident staging and follow-up without a biopsy in most patients. Using Albert’s case, a 65-year-old with steatosis and mild ALT elevation, she explains how to apply FIB-4 first, then layer in FibroScan/VCTE with Liver Stiffness (kPa) and CAP for fat quantification, plus when to order ELF or MRI elastography. You’ll learn reliability checks for FibroScan, common confounders, insurance/operational tips for MRE, and an easy algorithm for primary care/endocrine clinics: start with FIB-4 → triage by cutoffs → use VCTE/ELF → refer when intermediate or high risk. She closes with clear next steps for low-risk patients—lifestyle modification, cardiometabolic optimization, and repeating NITs in 2–3 years—and when to escalate to hepatology for advanced disease.
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