Chat with MASLD AI
Hi, I am MASLD AI.
Suggested Questions :
MASLD AI 09:05 PM
July 2025
In this episode of the GHAPP MASLD podcast series, Lavinia Iordache, PA-C from the University of Miami, shares expert guidance on monitoring metabolic dysfunction-associated steatotic liver disease (MASLD) in patients with type 2 diabetes—a group at particularly high risk for disease progression. Lavinia explains the bidirectional relationship between MASLD and diabetes, highlighting the importance of early screening, timely non-invasive testing (NITs), and proactive management strategies to prevent advanced fibrosis and cirrhosis. She reviews essential tools such as FIB-4, ELF score, FibroScan, and MRI-PDFF, and offers clear recommendations on when to escalate care, refer to specialty clinics, or intensify follow-up. The discussion also covers the role of lifestyle interventions including the Mediterranean diet, intermittent fasting, exercise, and coffee consumption, as well as strategies to improve adherence despite psychosocial, cultural, or financial barriers. Lavinia emphasizes a multidisciplinary approach to managing MASLD and provides practical tips for tracking lifestyle changes, such as journaling and the use of the EDAS questionnaire. Whether you’re a GI, endocrinology, or primary care provider, this episode offers an actionable roadmap for reducing liver-related complications in patients with diabetes.
Related Podcast
Alcohol and MASLD/MASH: Navigating the Complex Relationship
July 2025
In this insightful episode, Oyin Penny, NP with Premier Gastroenterology of Kansas City, addresses the complex clinical challenge of managing patients with MASLD (metabolic dysfunction-associated steatotic liver disease) who also consume alcohol. Oyin shares practical, evidence-based strategies for screening alcohol use in MASLD and MASH, emphasizing the importance of creating a nonjudgmental, patient-centered environment. She outlines how to use tools like PEth (phosphatidylethanol) testing to objectively quantify alcohol intake and explains the synergistic hepatotoxicity that occurs when alcohol use coexists with metabolic liver disease. Oyin also explores when to initiate non-invasive tests (NITs), why alcohol can distort fibrosis staging, and how to time assessments and treatment appropriately. From setting SMART goals to recommending behavioral support, medications like naltrexone, and exploring mental health and social work interventions, this episode offers a full-spectrum approach to managing high-risk patients. Whether you're a GI, hepatology provider, or in primary care, this episode provides tools for personalized care, alcohol harm reduction, and effective long-term MASLD management.
Watch Now
The Role of Exercise in Liver Health
July 2025
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.
Watch Now
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.
Watch Now
Serological Workup: A Step-by-Step Guide
July 2025
In this comprehensive video, Sherona Bau, NP from UCLA, breaks down the essential hepatology workup for patients with MASLD (formerly NAFLD) and MASH, offering guidance for both primary care providers and GI/hepatology specialists. Drawing from her extensive clinical experience, she outlines a systematic approach to evaluating abnormal liver ultrasound findings—starting with critical labs to rule out chronic liver conditions like hepatitis B, hepatitis C, autoimmune hepatitis, PBC, and hereditary hemochromatosis. Sherona discusses the importance of ordering ANA, AMA, ferritin, serologies, and even specialized labs like the phosphatidylethanol (PEth) test to uncover alcohol-related liver disease that may be overlooked. She emphasizes the need to screen for cardiometabolic risk factors including type 2 diabetes and dyslipidemia and highlights non-invasive tests such as FibroScan and FIB-4 to help identify patients at risk of advanced fibrosis who may benefit from specialist referral. Most importantly, Sherona addresses the fears many patients face around liver disease progression and life expectancy, encouraging early intervention and coordinated care to improve long-term outcomes. This video is a must-watch for any clinician managing steatotic liver disease.
Watch Now
MASH/MASLD in Type 2 Diabetes: Concurrent Medication Management
July 2025
In this informative episode, Whitney Steinmetz, NP from Presbyterian Medical Group in Albuquerque, NM, explores how to optimize medication strategies for patients with type 2 diabetes who are also living with MASLD and MASH. She discusses why individuals with type 2 diabetes are at significantly higher risk for developing advanced liver fibrosis—highlighting the overlapping metabolic, inflammatory, and insulin-resistant pathways that accelerate liver damage. Whitney breaks down how commonly prescribed diabetes medications—like GLP-1 receptor agonists, SGLT2 inhibitors, TZDs, and dual/triple incretins—impact liver fat, inflammation, and fibrosis progression. She offers practical guidance on selecting therapies that balance glycemic control with hepatic benefits while minimizing polypharmacy. Learn which medications may offer dual cardiometabolic and hepatic advantages, and which should be avoided or used with caution in patients with cirrhosis or advanced fibrosis. Tune in for real-world insights into how advanced practice providers can take ownership of MASH management in diabetes care.
Watch Now
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.
Watch Now
Diet and Nutrition: Tailoring Plans for Diverse Populations
July 2025
In this quick and practical video, Miu Lai Ng, a nurse practitioner at the hepatology clinic at Tufts Medical Center in Boston, shares simple, culturally sensitive, and cost-effective dietary tips to help patients manage fatty liver disease—also known as MASH (metabolic dysfunction–associated steatohepatitis). From avoiding white-colored refined carbs like sugar, white rice, and potatoes to smart swaps like oatmeal—rich in soluble fiber and low on the glycemic index—this video emphasizes realistic changes tailored to diverse backgrounds. Miu Lai Ng also covers powerful tools for sticking with a liver-friendly diet, including food tracking apps, photo logging, meal planning tools, and the importance of social support. Plus, she highlights the hidden dangers of liquid calories found in sodas, juices, and bubble tea, which spike liver fat and cost more than you think. Whether you're supporting a patient or managing MASH yourself, this video offers actionable advice that respects both culture and budget—because small changes can lead to big results for your liver and your life.
Watch Now
Podcast: Pharmacotherapy for MASH/MASLD: An Overview
June 2025
In this informative episode, Lindsay Yoder, PA, a hepatology expert at Indiana University, provides a comprehensive overview of current pharmacotherapy options for MASH (Metabolic Dysfunction–Associated Steatohepatitis), focusing on the first FDA-approved medication, resmetirom (brand name: Rezdiffra). Speaking directly to the MASLD/MASH Community Network, Lindsay breaks down the key histologic endpoints that led to resmetirom’s conditional approval—namely, fibrosis improvement without worsening of steatohepatitis, and MASH resolution without worsening fibrosis. She shares real-world data from clinical trials showing that resmetirom nearly doubles the rate of fibrosis improvement and triples MASH resolution compared to placebo. Lindsay also explains how the drug works: as a thyroid hormone receptor beta agonist, resmetirom improves hepatic lipid metabolism, reduces liver fat, and dampens inflammation—all key drivers of MASH progression. She outlines ideal patient criteria (stage F2–F3 fibrosis without cirrhosis), safety considerations, tolerability, potential side effects, and statin interactions. With an emphasis on combining pharmacotherapy with lifestyle changes, this episode serves as a practical guide for clinicians treating patients with MASH who qualify for advanced intervention.
Watch Now
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.
Watch Now
Beyond Basic NITs: When is Liver Biopsy or Advanced Imaging
July 2025
In this episode, Brian Lam, PA, Associate Director of Research at Inova’s Liver and Obesity Research Program in Northern Virginia, explores the nuanced decision-making involved in going beyond basic non-invasive tests (NITs) for diagnosing and managing MASH (metabolic dysfunction-associated steatohepatitis). While FIB-4 and transient elastography are useful initial tools, Brian breaks down when and why clinicians should consider more advanced diagnostics—such as MR elastography (MRE), proton density fat fraction (PDFF), and in certain cases, liver biopsy. Learn how to assess the reliability of a TE exam, interpret discordant NITs, and when to escalate to cross-sectional imaging or histologic confirmation. This podcast also highlights the evolving role of fat fraction in therapy response, limitations in current FDA indications for resmetirom, and how emerging data may shape future clinical pathways for patients with compensated cirrhosis. Whether you're in primary care, GI, or hepatology, this discussion offers critical insights to improve accuracy in staging liver disease and optimizing treatment strategies for patients with MASH.
Watch Now