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August 2025
In this educational session, Gabriella McCarty, NP at North Shore Gastroenterology, shares practical insights into Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH. Drawing from over 25 years of experience in GI, IBD, and hepatology, she explains how many fatty liver patients are discovered incidentally during workups for unrelated issues such as GERD or routine colonoscopy. Gabriella reviews the new global terminology (MASLD replacing NAFLD, MASH replacing NASH), outlines key metabolic risk factors that define MASLD, and walks through the role of non-invasive tests (FIB-4, FibroScan, ELF, ultrasound) in staging fibrosis. She emphasizes the importance of early detection, patient education, and primary care involvement in identifying at-risk individuals before progression to advanced fibrosis, cirrhosis, or liver cancer. This presentation highlights how MASLD can silently progress, why primary care and GI collaboration are critical, and the growing need for global awareness and prevention of progressive liver disease.
Related Podcast
LFTs Demystified: A practical guide for APPs
July 2025
In this GHAPP MASLD Community Network podcast, Jessica Crimaldi, NP, from the Cleveland Clinic, provides practical, real-world insights into interpreting liver function tests (LFTs) in the context of MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (steatohepatitis). Drawing on over a decade of experience in GI and hepatology, Jessica explains common ALT and AST elevation patterns that should prompt a diagnostic workup, even in asymptomatic patients. She reviews the hepatocellular vs. cholestatic patterns of injury, the value of the R-factor calculator in identifying the likely etiology of liver enzyme abnormalities, and how to differentiate MASH from other liver diseases such as PBC, viral hepatitis, or bile duct obstruction. The episode also addresses key non-liver labs like triglycerides, A1C, and cholesterol, and how they contribute to assessing metabolic risk. Finally, Jessica discusses the role of serial LFT monitoring in evaluating treatment response—highlighting what it means when liver enzyme levels fall and why "normal" LFTs don’t always indicate disease resolution. Whether you're a primary care provider or hepatology specialist, this podcast offers valuable guidance for early detection, risk stratification, and longitudinal monitoring of patients with 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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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.
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MASLD Basics With Maribeth Capuno
August 2025
Join us for an in-depth overview of steatotic liver disease, presented through the GHAPP MASLD/MASH Community Network and proudly sponsored by Madrigal Pharmaceuticals. This engaging session walks through the updated terminology replacing NAFLD and NASH with MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction-Associated Steatohepatitis)—explaining what the name change means and how to apply the latest AASLD 2023 guidelines in clinical practice. Learn how to identify MASLD based on cardiometabolic risk factors, rule out other causes of steatosis such as alcohol use, autoimmune conditions, and hereditary liver diseases, and determine when to use non-invasive testing like FIB-4, FibroScan, and ELF to stratify fibrosis risk. With Global Fatty Liver Day around the corner, this timely presentation also highlights the global burden of MASLD, its progression from steatosis to cirrhosis and HCC, and practical steps for primary care and hepatology teams to intervene early. You'll follow the case of JP, a 55-year-old with obesity, pre-diabetes, and elevated liver enzymes, as a real-world example of how to evaluate, diagnose, and manage MASLD—and when to refer to hepatology for advanced care. Whether you're a GI provider, APP, or primary care clinician, this talk offers a practical roadmap for managing fatty liver disease in 2025 and beyond.
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HCC Surveillance: Implementation in Patients with Advanced Fibrosis/Cirrhosis from MASH
July 2025
In this episode of the GHAPP MASLD Community Network podcast, Lisa Richards, a hepatology-focused nurse practitioner in San Diego, shares expert insights on hepatocellular carcinoma (HCC) surveillance for patients with advanced fibrosis and cirrhosis due to MASH (metabolic dysfunction-associated steatohepatitis). Lisa outlines which patients require routine HCC surveillance, emphasizing the importance of staging—particularly stages F3 and F4—and how AASLD guidelines guide surveillance strategies. She discusses recommended surveillance modalities, including ultrasound with AFP every six months, and introduces the LIRADS visualization score to help interpret imaging quality and follow-up needs. Lisa also addresses practical challenges in implementation, from patient education and engagement to overcoming barriers like cost, transportation, and care coordination. For advanced practice providers (APPs), this podcast delivers clear guidance on what to do when new liver lesions are detected and how to proceed with diagnostic imaging and referrals for multidisciplinary review or intervention. Empower your clinical practice with strategies that promote early detection and improve outcomes in patients at risk of HCC.
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MASLD Pharmacotherapy With Kelly Smeester
August 2025
Join Kelly Smeester, MMS, RD, PA-C, from South Denver Gastroenterology for an in-depth pharmacologic review of current and emerging treatment options for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH (Metabolic Dysfunction-Associated Steatohepatitis), as part of the GHAPP MASLD Community Network. This session outlines a comprehensive treatment strategy focused on three key goals: promoting weight loss, reducing cardiovascular risk, and targeting liver-specific interventions. Kelly highlights lifestyle and pharmacologic interventions including GLP-1 receptor agonists, GIP/GLP-1 dual agonists, and bariatric surgery, while exploring evidence-based guidance for treating comorbidities like type 2 diabetes, hypertension, and dyslipidemia. She dives into the latest data on vitamin E, pioglitazone, and the newly FDA-approved Resmetirom (Rezdiffra)—a thyroid hormone receptor beta agonist indicated for adults with non-cirrhotic NASH and F2–F3 fibrosis. Learn about the results from pivotal clinical trials like ESSENCE, PIVENS, and MAESTRO-NASH, the importance of NAFLD activity scoring, as well as dosing strategies, adverse effects, and drug interactions to consider when using Resmetirom. The session also explores practical monitoring approaches including FibroScan, MRI-PDFF, and ELF scores, with an outlook on evolving treatment duration and insurance coverage considerations. Whether you're a hepatology provider or part of a multidisciplinary care team, this presentation offers critical insights to optimize MASH treatment pathways today and in the future.
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Podcast: PCP Screening for MASH/MASLD: Identifying At-Risk Patients
July 2025
In this essential podcast episode from the GHAPP MASLD/MASH Community Network, Summer Collier, NP at UC San Diego Health, dives into the critical role that primary care providers and advanced practice providers play in recognizing and managing MASLD (Metabolic dysfunction-associated steatotic liver disease) and its progressive form, MASH (Metabolic-associated steatohepatitis). With MASLD affecting a growing number of patients—many undiagnosed—Summer walks through practical strategies for early identification, starting with high-risk individuals such as those with type 2 diabetes, obesity, or metabolic syndrome. She highlights the use of the FIB-4 index as a quick, validated, and guideline-recommended first-line screening tool, and explains how to interpret FIB-4 results to stratify risk and determine next steps, including ELF testing, FibroScan®, or referral to GI/hepatology. Summer also offers actionable workflow tips to integrate liver screening into routine primary care, like embedding FIB-4 calculators in EMRs or incorporating assessments into annual diabetes visits. This episode is a must-listen for clinicians seeking to prevent liver fibrosis progression and liver cancer through early, proactive care.
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Non-Invasive Testing With Erin Tanner
July 2025
In this educational session from the GHAPP MASLD & MASH Community Network, Erin Tanner, PA-C from Gastro Health in Birmingham, Alabama, presents a practical overview of non-invasive testing (NIT) options for evaluating and managing MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic dysfunction-associated steatohepatitis). Using a patient case study, Erin explores how clinicians can effectively utilize tools like FIB-4, FibroScan® (VCTE and CAP), ELF, MRE, and other emerging imaging and serum biomarkers to assess hepatic steatosis and fibrosis without the need for liver biopsy. The talk breaks down the pros, cons, and clinical accuracy of various NITs—including shear wave elastography, MRI-PDFF, and proprietary serum markers—and offers guidance on how to apply these tools in real-world hepatology and primary care settings. Special attention is given to identifying patients with metabolic risk factors, interpreting indeterminate FIB-4 scores, and knowing when to refer patients for further hepatology evaluation. Whether you’re new to liver disease management or looking to update your MASLD/MASH care pathways, this session offers clarity on how to stratify fibrosis risk and make informed clinical decisions using non-invasive diagnostics.
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MASLD Basics With Ellie Gonyeau
August 2025
Join Ellie Gonyeau, NP, a GI and hepatology nurse practitioner at Beth Israel Deaconess Medical Center in Boston, for a foundational overview of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as NAFLD. Presented through the GHAPP MASLD Community Network and sponsored by Madrigal Pharmaceuticals, this session covers the latest updates in MASLD nomenclature, diagnostic criteria, and non-invasive evaluation strategies. Ellie walks through the 2023 guidelines, emphasizing how MASLD is defined by hepatic steatosis in the presence of at least one metabolic risk factor—such as obesity, type 2 diabetes, hypertension, or dyslipidemia—and the importance of ruling out excessive alcohol use and other causes of chronic liver disease. Using real-world case examples like "JP", Ellie illustrates how to assess disease severity using tools such as FIB-4, FibroScan, and lab workups, while explaining when to consider specialty referral, further imaging, or liver biopsy. The talk also highlights the alarming rates of MASLD in high-risk populations, such as the Latin American community, and explores the disease's potential to silently progress to MASH, fibrosis, or cirrhosis. Whether you're in primary care, GI, or hepatology, this session provides critical insights on early detection, risk stratification, and guideline-based management of this increasingly prevalent condition.
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MASLD Basics With Scott Springer
August 2025
Welcome to the GHAPP MASLD Community Network, where Scott Springer, PA-C, from Erie County Medical Center in Buffalo, NY, provides a comprehensive overview of the evolving landscape of steatotic liver disease. Sponsored by Madrigal Pharmaceuticals, this session breaks down the recent nomenclature shift from NAFLD/NASH to MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction-Associated Steatohepatitis). Scott explores how overlapping etiologies like alcohol-associated liver disease (ALD) and the emerging classification of MetALD better reflect real-world patient populations. Learn about key diagnostic strategies—including the use of FIB-4, ELF score, and transient elastography—to assess fibrosis risk and guide referral to hepatology care. With a clinical case study, Scott highlights the importance of accurate staging, ruling out alternative etiologies, and understanding progression rates in high-risk patients. This session is a must-watch for GI and hepatology APPs looking to stay updated on guidelines, non-invasive diagnostics, and best practices for managing MASLD/MASH in primary and specialty settings.
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