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MASLD AI 02:59 PM
July 2025
Join Michelle Barnett, PA-C, for an in-depth clinical case presentation as part of the GHAPP MASLD Community Network. With over 25 years of experience in GI and hepatology, Michelle walks through the real-world management of Albert, a 65-year-old patient newly diagnosed with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease). In this session, she outlines key diagnostic criteria, the role of non-invasive tests (NITs) like FIB-4 and FibroScan, and how to risk-stratify patients using updated care pathways. Learn how to differentiate low-, moderate-, and high-risk cases and when to refer for hepatology evaluation or consider biopsy. Michelle also explores the clinical role of Resmetirom—the first FDA-approved medication for patients with MASH and F2-F3 fibrosis—and emphasizes the importance of sustained lifestyle modification, dietary change, and exercise in liver disease management. This expert discussion includes cultural and socioeconomic considerations, adherence strategies, and patient tools like the Exercise and Diet Adherence Scale. Visit the GHAPP MASLD Community Network for more resources, disease-state education, and updates on the evolving care landscape. Educational content supported by Madrigal Pharmaceuticals.
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LFTs Demystified: A Practical Guide for APPs
July 2025
In this informative session, Anthony Derencius, PA-C and sub-investigator at Pinnacle Clinical Research, provides a practical and accessible breakdown of liver function tests (LFTs) and liver-associated enzymes, with a focus on their role in diagnosing and monitoring fatty liver disease—including MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (metabolic-associated steatohepatitis). Drawing from years of experience in both general and transplant hepatology, Anthony explains how to interpret key markers like ALT, AST, alkaline phosphatase, bilirubin, albumin, and GGT. He emphasizes why elevated or even normal LFTs don’t always tell the whole story, and how a full workup—including viral hepatitis panels, autoimmune markers, alcohol-related labs, imaging, and non-invasive fibrosis assessments—can help uncover the root cause of liver injury. This video also walks viewers through when to consider additional tools like FIB-4, ELF score, FibroScan, or even liver biopsy. Whether you're a primary care provider or hepatology specialist, this session will sharpen your ability to distinguish between benign lab variations and signs of serious liver disease, ultimately supporting earlier diagnosis and better outcomes for your patients.
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Comparing F3 and F4 Fibrosis With Robin Soto
July 2025
In this in-depth case-based session from the GHAPP MASLD/MASH Community Network, Robin Soto, NP from UC San Diego Health, explores the clinical nuances of diagnosing and managing fibrosis stage 3 versus stage 4 in patients with MASH (Metabolic Dysfunction–Associated Steatohepatitis). Using a real-world case study of a patient named Sam, Robin demonstrates how to interpret and reconcile non-invasive tests (NITs) like FIB-4, FibroScan, CAP score, and ELF test to guide accurate staging. She offers practical insights into treatment decisions, including when to use resmetirom, the importance of lifestyle modification, and how to assess comorbidities like diabetes, obesity, and cardiovascular risk. The session also outlines when and how to monitor for hepatocellular carcinoma (HCC), implement liver cancer surveillance strategies, and approach multidisciplinary care for advanced fibrosis or cirrhosis. Whether you’re a hepatology specialist or a primary care provider, this video equips you with evidence-based tools for managing MASLD and optimizing outcomes in complex liver disease.
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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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In this GHAPP MASLD Community Network session, Jonathan Yeh, PA-C from Columbia University Irving Medical Center, presents a case-based discussion on the lifestyle management of MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). Through the case of a 65-year-old patient with obesity, type 2 diabetes, hypertension, and hyperlipidemia, Jonathan highlights how dietary modification, weight loss, and physical activity remain the foundation of treatment, even with new pharmacotherapies available. The presentation emphasizes the benefits of the Mediterranean diet, the importance of avoiding refined carbohydrates, and the role of both aerobic and resistance exercise in improving liver health, reducing steatosis, and potentially reversing fibrosis. Cultural considerations, patient adherence challenges, and strategies to drive behavior change are also addressed, providing clinicians with practical insights to support patients in preventing progression to advanced fibrosis or cirrhosis.
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Lifestyle Management With Jennifer Geremia
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In this GHAPP MASLD Community Network presentation, Jennifer Geremia, PA-C, from Brigham and Women’s Hospital in Boston, discusses the critical role of lifestyle modifications in managing MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). Using a case-based approach, she highlights how patients with obesity, type 2 diabetes, hypertension, and hyperlipidemia can benefit from evidence-based interventions including dietary changes, weight reduction, and physical activity. The session emphasizes the importance of achieving and maintaining 7–10% weight loss, the benefits of a Mediterranean diet, and combining aerobic and resistance exercise to improve liver health and reduce progression to advanced fibrosis or cirrhosis. Jennifer also explores the challenges of long-term adherence, the impact of genetic and metabolic risk factors, and strategies for engaging patients in realistic and sustainable lifestyle changes. This program underscores how early intervention and multidisciplinary care can prevent liver disease progression and improve outcomes for at-risk patients.
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The Role of Exercise in Liver Health
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In this episode, Suzanne Robertazzi, DNP at the Washington DC VA Medical Center, discusses the vital role of exercise in liver health, especially for patients at risk of or living with MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH. With a background in liver transplant care, Suzanne emphasizes the importance of tailoring exercise recommendations to each patient’s abilities, goals, and environment. She outlines practical, empathetic strategies for setting realistic fitness goals, celebrating small milestones, and integrating physical activity with nutritional counseling and behavioral support. Whether it's walking, swimming, or group classes, Suzanne explores low-cost and community-based options for promoting long-term adherence. This episode also highlights the benefits of a multidisciplinary approach, including collaboration with physical therapists, mental health professionals, and dietitians. Packed with actionable insights, this conversation is essential for healthcare providers working to empower patients with fatty liver disease through sustainable lifestyle interventions.
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Podcast: Role of Exercise in Liver Health
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In this engaging episode of the GHAPP MASLD/MASH Community Network podcast, Jonathan Yeh, PA at Columbia University Medical Center, discusses the essential role of exercise in liver health—especially in managing MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). With over 14 years of hepatology experience, Jonathan breaks down the most effective types of physical activity, highlighting the benefits of combining aerobic and resistance training over high-intensity interval training (HIIT) alone. He provides practical, personalized exercise recommendations tailored to patients’ physical abilities, access to resources, and comorbidities—including suggestions for those with mobility limitations or time constraints. Jonathan also offers motivational strategies to help patients overcome common barriers such as lack of time, motivation, or access to fitness facilities. From parking farther from a destination to lunchtime walks and home-based workouts using resistance bands, he emphasizes creative and realistic ways to build physical activity into daily routines. Beyond weight loss, he explains how exercise directly improves liver function by reducing liver fat, enhancing insulin sensitivity, and preventing fat and sugar buildup in the liver. This episode is a must-watch for clinicians and patients alike seeking to understand and implement exercise as a cornerstone in the management of fatty liver disease.
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