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MASLD AI 12:28 PM
October 2025
Learn from Lindsay Pratt, PA-C at the University of Colorado Hepatology Clinic, as she explores the evolving landscape of metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic dysfunction and alcohol-associated liver disease (MetALD) in this comprehensive, case-based discussion. Drawing on over 15 years of experience in hepatology and liver transplantation, Lindsay walks through real-world evaluation and management of a 52-year-old patient with hepatic steatosis, highlighting key diagnostic clues, lab interpretations, and the importance of incorporating objective biomarkers such as PEth testing to accurately assess alcohol use. This educational session provides clarity on differentiating MASLD, MASH, and MetALD, interpreting FibroScan results, and addressing cardiometabolic risk factors like obesity, hypertension, and hyperlipidemia. Pratt also emphasizes practical treatment strategies, including lifestyle modification, GLP-1 therapy, and alcohol cessation counseling, along with considerations for emerging therapies like resmetirom (Rezdiffra). APPs and hepatology clinicians will gain valuable insights into patient communication, disease classification, and evidence-based management approaches that can help slow progression, reduce fibrosis risk, and optimize liver outcomes.
Related Podcast
MASLD Pharmacotherapy With Tessa Janovsky
September 2025
Join Tessa Janovsky, PA-C from Arizona Liver for a practical update on MASLD pharmacotherapy—from whole-patient metabolic management to liver-directed treatment. This session reviews why care must target the entire metabolic syndrome (weight, type 2 diabetes, hypertension, dyslipidemia, cardiovascular risk), the impact of 7–10% weight loss (and why many patients need adjuncts), and how to choose between diet/physical activity, anti-obesity medications, and bariatric surgery for select cases. You’ll learn where GLP-1 receptor agonists fit (mechanism, expected weight and glycemic effects, GI side effects, peri-procedure anesthesia considerations, and use in compensated disease), when to use statins safely in fatty liver, and how to stage and monitor with FIB-4, FibroScan/elastography, and other non-invasive tests. Tessa also summarizes legacy data for vitamin E and pioglitazone (benefits and limitations) and highlights the first FDA-approved therapy for non-cirrhotic MASH with F2–F3 fibrosis, resmetirom—including mechanism (THR-β agonism), tolerability, drug–drug interaction checkpoints, and practical follow-up (restaging and lifestyle coaching). If you’re a GI/hepatology clinician or APP aiming to streamline risk reduction, staging, and evidence-based therapy for MASLD/MASH, this concise talk delivers clinic-ready guidance.
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Lifestyle Management With Jennifer Geremia
August 2025
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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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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Lifestyle Management With Anthony Derencius
July 2025
Join Anthony Derencius, PA-C, at Pinnacle Clinical Research, for an in-depth, case-based discussion on the role of lifestyle management in MASH and MASLD. In this educational session from the GHAPP MASLD Community Network, Anthony walks through the real-world case of a 65-year-old patient with obesity, diabetes, and suspected metabolic liver disease, highlighting how to interpret non-invasive diagnostics like FIB-4 scores and transient elastography. He explains the clinical significance of metabolic risk factors, genetic predispositions (such as PNPLA3), and how personalized approaches to nutrition and exercise can alter the progression of fatty liver disease. With evidence-based insights on the Mediterranean diet, aerobic vs resistance training, and behavior change strategies, this video offers frontline strategies to support patients in reversing or slowing fibrosis. Watch to learn how providers can combine patient education, lifestyle interventions, and emerging pharmacotherapy to manage MASLD and MASH more effectively. Educational support provided by Madrigal Pharmaceuticals. For more disease state content, visit the GHAPP MASLD Community Network.
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MASLD Basics With Emily Przybyl
September 2025
Emily Przybyl, PA-C, breaks down the basics of Steatotic Liver Disease (SLD) and the updated MASLD/MASH nomenclature—what changed, why it matters, and how to apply it in daily practice. You'll learn how to distinguish MASLD, MetALD, and alcohol-associated liver disease, interpret alcohol exposure (weekly vs. daily intake), and recognize non-metabolic causes of steatosis (DILI, monogenic disorders, viral hepatitis). Emily walks through primary care–friendly risk assessment using FIB-4, when to order VCTE/FibroScan or the ELF test, when to refer to hepatology, and when liver biopsy is still the right move in discordant cases. Using a real patient case, Emily demonstrates a stepwise chronic liver disease workup (viral serologies, iron studies, autoimmune markers, celiac, A1AT, HIV, lipids, A1C, and PEth for alcohol), plus how ultrasound findings (steatosis, smooth contour, spleen size) inform staging. She reviews natural history and progression (who’s at risk to advance to fibrosis/cirrhosis), the roles of genetics and the gut microbiome, and practical counseling on lifestyle modification—BMI/waist thresholds by ethnicity, cardiometabolic risk control, and culturally sensitive nutrition and exercise plans. Perfect for APPs, primary care, and hepatology teams looking for a clear, actionable primer on MASLD/MASH.
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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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Misconceptions About Liver Health
July 2025
In this quick but powerful video, Jeremy Davis, NP from Shreveport, Louisiana, addresses some of the most common misconceptions about liver health that he encounters in clinical practice. Many patients believe that liver disease only occurs in people who drink alcohol, but Jeremy explains how conditions like MASLD (Metabolic dysfunction-associated steatotic liver disease) and MASH (Metabolic-associated steatohepatitis) can affect individuals regardless of alcohol use. He also clears up the myth that only overweight patients are at risk, pointing out that co-morbidities such as hypertension, high cholesterol, cardiovascular disease, and type 2 diabetes can contribute to liver disease—even in patients with a normal BMI. Finally, Jeremy explains why normal liver enzyme labs (ALT and AST) don’t always rule out liver disease, making it crucial to assess underlying risk factors and improve provider and patient awareness. This video is a valuable resource for both healthcare professionals and patients looking to better understand non-alcoholic liver disease and why early screening matters.
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Common Questions From Primary Care Providers About MASH
August 2025
Join Sarah Dawkins, NP, for quick and practical insights in this edition of GHAPP MASLD Community Network’s APP Insights. Sarah answers common questions from primary care providers about managing patients with hepatic steatosis on imaging but normal liver tests. She explains when to calculate a FIB-4 score, how to interpret mild ALT/AST abnormalities, and when referral to hepatology is necessary. Learn how to assess risk in patients with diabetes, obesity, or metabolic syndrome, and how to rule out other causes like viral hepatitis, alcohol use, drug-induced liver injury, and iron overload. Sarah emphasizes the importance of lifestyle counseling for low-risk patients and provides a clear framework for primary care providers to confidently monitor and manage MASLD without unnecessary referrals. A must-watch for anyone navigating the "gray zone" of liver diagnostics in everyday practice.
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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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Comparing F3 and F4 Fibrosis With Maribeth Capuno
August 2025
Join Maribeth Capuno, DNP, from the Richmond VA Medical Center, for an insightful case-based discussion on F3 vs. F4 fibrosis staging in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and MASH, presented through the GHAPP MASLD/MASH Community Network and sponsored by Madrigal Pharmaceuticals. Using the fictional case of “Sam,” Maribeth demonstrates how to differentiate between F3 and F4 fibrosis using non-invasive tools like FIB-4, FibroScan, and the ELF test, while explaining their respective cutoffs and clinical implications. Learn how to stage MASLD accurately, when to consider MRI elastography or liver biopsy, and how to initiate evidence-based management strategies including lifestyle modification, GLP-1 therapy, and the newly approved medication Resmetirom (Rezdiffra). The session highlights the importance of HCC surveillance, portal hypertension screening, and the nuances in monitoring between F3 and F4 fibrosis stages. With a strong emphasis on practical, guideline-aligned hepatology care, this video provides essential insights for clinicians managing the growing MASLD population.
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