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MASLD AI 01:57 AM
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.
Related Podcast
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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Common Questions From Primary Care Providers About MASH With Stacie Egan
September 2025
In this educational session, Stacie Egan, DNP at Ogden Clinic GI in Ogden, Utah, shares practical insights on managing patients with MASH and fibrosis in clinical practice. Drawing from her experience treating patients with F2–F3 fibrosis, Stacy highlights the effectiveness of emerging pharmacotherapies and the positive outcomes she has seen in her patients. She emphasizes the critical role of primary care providers as gatekeepers in identifying at-risk patients, particularly those with metabolic syndrome, type 2 diabetes, obesity, hypertension, or hyperlipidemia. By utilizing simple tools like the FIB-4 score, primary care teams can begin the process of risk stratification and ensure that patients receive timely referrals for additional testing such as FibroScan, MRE, or liver biopsy. Stacie also discusses the importance of distinguishing between low, indeterminate, and high-risk patients, ensuring that those with advanced fibrosis (F2, F3, and F4) receive appropriate treatment, monitoring, and, when needed, referral to hepatology for transplant evaluation. This video serves as an important resource for providers across specialties, reinforcing the need for collaboration to detect and treat MASH with fibrosis early, improve patient outcomes, and help reverse steatosis and fibrosis.
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Non-Invasive Testing With HoChong Gilles
September 2025
In this MASLD Community Network webcast, HoChong Gilles, NP, from the Central Virginia VA Health Care System, provides a comprehensive overview of the evolving role of non-invasive testing (NITs) in diagnosing and staging MASLD and MASH. Using a real-world case example, she demonstrates how tools such as FIB-4, ELF (Enhanced Liver Fibrosis) score, FibroScan (VCTE), MR Elastography, and ultrasound can help clinicians accurately stratify risk, detect significant fibrosis, and avoid unnecessary liver biopsies. HoChong explains the strengths, limitations, and quality considerations of each modality—highlighting how to interpret cut-offs, manage indeterminate results, and incorporate these tests into routine hepatology and GI practice. The session reinforces the importance of combining NIT results with metabolic risk factor management and underscores why accurate staging is essential as new therapies like resmetirom (Rezdiffra) become available for non-cirrhotic patients with F2–F3 fibrosis.
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Common Questions From Primary Care Providers About MASH
August 2025
In this MASLD Community Network episode, Edith Johannes, NP at UCLA Health, shares evidence-based guidance on one of the most important questions in managing Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction–Associated Steatohepatitis (MASH): how much weight loss is needed to improve liver health. Drawing on years of experience in hepatology and liver transplant care, Edith explains how weight loss can reduce liver fat (steatosis), decrease inflammation, improve or even reverse fibrosis, and support better overall metabolic health. Research shows that achieving more than 10% weight loss can result in 100% improvement in steatosis, MASH resolution in 90% of patients, and fibrosis regression in over 80%. Even smaller amounts of weight loss—5% to 10%—provide significant liver and metabolic benefits, while exercise and dietary changes can help improve liver function even without weight loss. Edith also discusses when additional treatments like GLP-1s, bariatric surgery, or resmetirom may be needed. This video is essential for healthcare providers, patients, and caregivers seeking practical, science-backed strategies to manage MASLD and MASH effectively.
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Alcohol and MASLD/MASH: Navigating the Complex Relationship
August 2025
Join Edith Johannes, NP, UCLA Health, for an in-depth discussion on alcohol consumption in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Alcohol-Related Liver Disease (MetALD). Drawing on over 17 years of experience in liver disease and transplant care, Edith explains the clinical importance of accurately screening and quantifying alcohol use to differentiate between MASLD, MetALD, and Alcohol-Related Liver Disease (ALD). Learn the acceptable alcohol thresholds, how alcohol impacts diagnostic accuracy for fibrosis, and why precise history-taking—down to grams per day—is essential for guiding treatment. This session covers practical strategies for effective patient conversations, cultural sensitivity, use of validated screening tools (CAGE, AUDIT, AUDIT-C), and tips for uncovering underreported intake. Discover how alcohol use can confound non-invasive testing like FIB-4 and elastography, influence eligibility for pharmacotherapy, and accelerate disease progression, cardiovascular risk, and mortality. With a focus on early intervention, lifestyle modification, and multidisciplinary support for alcohol cessation, this talk provides actionable insights for improving liver health outcomes in MASLD and MetALD patients.
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Podcast: LFTs Demystified: A Practical Guide for APPs
June 2025
In this podcast episode, Michelle Barnett, PA-C, a liver disease specialist based in Colorado Springs, provides a clear and practical overview on demystifying liver enzyme abnormalities—particularly in the context of MASH (Metabolic Dysfunction–Associated Steatohepatitis) and MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease). With MASLD affecting nearly 1 in 4 American adults, understanding liver enzyme patterns is critical for early detection and effective management. Michelle breaks down commonly reported values from hepatic function panels—ALT, ALP (alkaline phosphatase), and total bilirubin—explaining what constitutes normal, acute, subacute, and chronic elevations. She walks through hepatocellular, cholestatic, mixed, and isolated hyperbilirubinemia patterns and what they reveal about underlying liver conditions such as MASH, alcohol-associated liver disease, viral hepatitis, biliary obstruction, and drug-induced liver injury. Whether you're a provider or a patient looking to better understand lab results, this episode delivers expert guidance on interpreting liver enzyme elevations to support more informed clinical decisions.
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Serological Workup: A Step-by-Step Guide With Jill Olmstead
September 2025
Join Jill Olmstead, DNP from Providence Health in Southern California for a step-by-step guide on working up patients with elevated liver enzymes in this MASLD & MASH Community Network podcast. Jill reviews how to distinguish acute vs. chronic liver injury, interpret patterns of hepatocellular vs. cholestatic damage, and order the right serologic tests, including viral hepatitis panels, autoimmune markers (ANA, ASMA, AMA), Wilson’s disease, alpha-1 antitrypsin deficiency, iron studies, and celiac screening. She highlights common causes such as alcohol use and MASLD—now one of the leading causes of liver transplantation—and explains when to use abdominal ultrasound, MRCP, or ERCP to assess for gallstones, biliary obstruction, or sludge. Jill also emphasizes the role of noninvasive fibrosis assessment (FIB-4 score, FibroScan®, fibrosis panels) in staging and treatment planning. With practical insights on history taking, medication review, alcohol counseling, and referral thresholds, this episode provides APPs, GI providers, and hepatology clinicians with a clear framework to evaluate and manage patients with abnormal liver tests and protect long-term liver health.
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PCP Screening for MASH/MASLD: Identifying At-Risk Patients
July 2025
In this episode, Jeremy Davis, NP from Gastrointestinal Specialists in Shreveport, Louisiana, discusses the vital role of primary care screening for MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH (metabolic-associated steatohepatitis). With the rising prevalence of metabolic co-morbidities like type 2 diabetes, hypertension, dyslipidemia, and obesity, early identification of at-risk patients is more critical than ever. Jeremy outlines practical and evidence-based strategies for screening in the primary care setting, starting with simple tools like the FIB-4 score—which relies on common lab values—and how to interpret results to guide referrals to hepatology or GI specialists. He also discusses the downstream workup upon referral, including non-invasive tests like FibroScan, ELF score, and liver ultrasound. Treatment fundamentals such as the Mediterranean diet, physical activity, and weight loss remain the cornerstone of care, while emerging therapies like GLP-1 agonists and resmetirom offer new options for high-risk patients. Whether you’re a PCP, APP, or specialist, this episode offers clear guidance on how to incorporate MASLD screening into everyday workflows to catch liver disease early and optimize outcomes.
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Common Questions from Patients About MASH
July 2025
In this focused episode, Suzanne Robertazzi, NP at the Washington DC VA, shares expert insights on how to prevent recurrence of MASH (Metabolic-associated steatohepatitis) and MASLD (Metabolic dysfunction-associated steatotic liver disease) in liver transplant recipients. Drawing on her experience caring for post-transplant veterans, Suzanne explains that MASH can return even after liver transplantation, making ongoing metabolic management essential. She outlines key strategies including tight blood sugar and blood pressure control, especially since transplant medications can contribute to hypertension. Suzanne also emphasizes the importance of introducing regular physical activity post-recovery and adopting a Mediterranean-style diet—while tailoring nutrition guidance to meet the needs of patients in urban settings with limited access to fresh foods. This video is a must-watch for transplant teams, hepatology providers, and patients seeking to extend the life and health of their new liver through evidence-based lifestyle and clinical interventions.
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Non-Invasive Testing With Jeremy Davis
September 2025
Join Jeremy Davis, NP, for a clear, clinic-ready walkthrough of non-invasive testing for MASLD/MASH. Using a real case, Jeremy shows how to risk-stratify patients starting with FIB-4 and when intermediate scores should trigger liver stiffness measurement. Learn practical cutoffs, image-quality checkpoints (valid measures, IQR/median), and common confounders (ALT/AST flares, cholestasis, recent meals, alcohol, obesity, ascites) that can overestimate stiffness. He contrasts pros/cons of VCTE vs. MRE, explains how to pair ELF with FibroScan, and maps decisions to AGA/AASLD-aligned pathways—who to refer, who to monitor, and how often to re-stage. The session closes with actionable counseling on lifestyle, weight loss targets, and cardiometabolic risk control to slow fibrosis progression while minimizing unnecessary biopsies.
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