Welcome to the only platform where you can connect with MASLD/MASH experts in your geographic area and stay up to date with disease state education in the form of short video modules and news articles.
Thought Leader
Mission of the MASLD Community
Dedicated to fostering collaboration, driving innovation, and improving outcomes for patients living with Metabolic Associated Steatotic Liver Disease.
Engage with MASLD/MASH Experts in Your Region
Connect with regional specialists for personalized guidance, professional training, and continuous support in MASLD/MASH.
Expert Insights
Benefit from expert-driven resources, including podcasts, publications, and practical tools designed for clinicians and patients.
Tailored Education for Your Community
Join your regional community network, where education is tailored to meet local needs. Collaborate with peers from local and regional communities, share knowledge, and drive impactful changes together.
Explore Our Events
Breakthroughs in MASH Diagnosis & Management
December 02 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with speakers Naim Alkhouri, MD, FAASLD, Pi..
Breakthroughs in MASH Diagnosis & Management
December 03 @ 06:30 pm - 09:30 pm CST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with speakers Fredric Regenstein, MD, Brian..
Breakthroughs in MASH Diagnosis & Management
December 09 @ 06:30 pm - 09:30 pm MST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with speakers Haripriya Maddur, MD, Geoffre..
Breakthroughs in MASH Diagnosis & Management
December 11 @ 06:30 pm - 06:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with speakers Hetal Karsan, MD, Julius Wild..
Breakthroughs in MASH Diagnosis & Management
January 13 @ 06:30 pm - 09:30 pm CST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Bradley Freilich, MD, AGAF, Steven Fla..
Breakthroughs in MASH Diagnosis & Management
January 14 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Satheesh Nair, MD, Ziad Younes, MD, &a..
Breakthroughs in MASH Diagnosis & Management
January 14 @ 06:30 pm - 09:30 pm PST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Sammy Saab, MD, MPH, Ke-Qin Hu, MD &am..
Breakthroughs in MASH Diagnosis & Management
January 15 @ 06:30 pm - 09:30 pm PST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Robert Wong, MD, M.S, Bilal Hameed, MD..
Breakthroughs in MASH Diagnosis & Management
January 22 @ 06:30 pm - 09:30 pm PST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Marina Roytman, MD, Paul Kwo, MD, &..
Breakthroughs in MASH Diagnosis & Management
January 29 @ 06:30 pm - 09:30 pm MST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Marcelo Kugelmas, MD, FAASLD, FACP, Ch..
Breakthroughs in MASH Diagnosis & Management
February 05 @ 06:30 pm - 09:30 pm CST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Mazen Noureddin, MD, MHSc. &nbs..
Breakthroughs in MASH Diagnosis & Management
February 10 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with David Bernstein, MD, Robert S. Brown, ..
Breakthroughs in MASH Diagnosis & Management
February 19 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with John Binu, MD, MPH, Pierre Gholam, MD,..
28th IU GI & Hepatology Update
February 27 @ 07:00 am - 03:25 pm EST
The IU Gastroenterology & Hepatology Update is an annual educational program designed for physicians, advanced practice providers (APPs), nurses, ..
Breakthroughs in MASH Diagnosis & Management
March 04 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Niharika Samala, MD...
Breakthroughs in MASH Diagnosis & Management
March 11 @ 06:30 pm - 09:30 pm CDT
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Nancy Reau, MD, Sujit Janardhan, MD, P..
Breakthroughs in MASH Diagnosis & Management
March 25 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Scott Minchenberg, MD, PhD, Michelle L..
Breakthroughs in MASH Diagnosis & Management
March 26 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Kimberly Brown, MD, Robert Fontana, MD..
Explore Our Events
CME EVENT
Breakthroughs in MASH Diagnosis & Management
December 02 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with speakers Naim Alkhouri, MD, FAASLD, Pi..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
December 03 @ 06:30 pm - 09:30 pm CST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with speakers Fredric Regenstein, MD, Brian..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
December 09 @ 06:30 pm - 09:30 pm MST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with speakers Haripriya Maddur, MD, Geoffre..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
December 11 @ 06:30 pm - 06:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with speakers Hetal Karsan, MD, Julius Wild..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
January 13 @ 06:30 pm - 09:30 pm CST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Bradley Freilich, MD, AGAF, Steven Fla..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
January 14 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Satheesh Nair, MD, Ziad Younes, MD, &a..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
January 14 @ 06:30 pm - 09:30 pm PST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Sammy Saab, MD, MPH, Ke-Qin Hu, MD &am..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
January 15 @ 06:30 pm - 09:30 pm PST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Robert Wong, MD, M.S, Bilal Hameed, MD..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
January 22 @ 06:30 pm - 09:30 pm PST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Marina Roytman, MD, Paul Kwo, MD, &..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
January 29 @ 06:30 pm - 09:30 pm MST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Marcelo Kugelmas, MD, FAASLD, FACP, Ch..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
February 05 @ 06:30 pm - 09:30 pm CST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Mazen Noureddin, MD, MHSc. &nbs..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
February 10 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with David Bernstein, MD, Robert S. Brown, ..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
February 19 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with John Binu, MD, MPH, Pierre Gholam, MD,..
CME EVENT
28th IU GI & Hepatology Update
February 27 @ 07:00 am - 03:25 pm EST
The IU Gastroenterology & Hepatology Update is an annual educational program designed for physicians, advanced practice providers (APPs), nurses, ..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
March 04 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Niharika Samala, MD...
CME EVENT
Breakthroughs in MASH Diagnosis & Management
March 11 @ 06:30 pm - 09:30 pm CDT
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Nancy Reau, MD, Sujit Janardhan, MD, P..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
March 25 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Scott Minchenberg, MD, PhD, Michelle L..
CME EVENT
Breakthroughs in MASH Diagnosis & Management
March 26 @ 06:30 pm - 09:30 pm EST
Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Kimberly Brown, MD, Robert Fontana, MD..
Featured MASLD/MASH Educators
Elizabeth Alqueza
PA-C
Elizabeth Alqueza, PA-C is a board certified Physician Associate at Beth Israel Deaconess Medical Center (BIDMC) in Boston, Massachusetts. She graduated from the University of Florida in 2004 with a Master of Physician Assistant Studies degree and subsequently completed the AASLD NP/PA Clinical Hepatology Fellowship. Elizabeth has worked in a variety of inpatient and outpatient settings with a strong commitment to patient care. Currently working at BIDMC Liver Center, Elizabeth has 5 years of dedicated experience in Hepatology. Her practice focuses primarily on steatotic liver disease, including Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH). Elizabeth is an active member of Gastroenterology and Hepatology Advanced Practice Providers.
Michelle Barnett
PA-C, MPAS, DFAAPA
Michelle Barnett is a highly experienced physician assistant specializing in patient-focused and evidence-based hepatology at Peak Gastroenterology Associates in Colorado Springs, Colorado. The most rewarding part of her position includes educating patients and collaborating with other GI advanced practice providers to enhance care for the growing MASLD/MASH population. She is now a subinvestigtor for hepatology clinical trials with Peak in Colorado Springs. With over 30 years in the GI and liver communities, she has held leadership roles, including serving as President of the Colorado Academy of Physician Assistants (CAPA) and receiving CAPA's Physician Assistant of the Year award. She is a national speaker and has given lectures for the AAPA, GHAPP and AANP. A graduate of Wichita State University and the University of Nebraska, Michelle has been recognized with the DFAAPA distinction and honors such as the Crohn’s and Colitis Foundation's IBD internship and the International Foundation for Gastrointestinal Disorders Ally Award. Passionate about holistic care, she incorporates lifestyle strategies like nutrition, yoga, and meditation into her practice. Outside of work, Michelle enjoys hiking, travel, musical theater, and supporting her favorite Colorado sports teams.
Sherona Bau
NP
Sherona Bau graduated from University of California, Los Angeles in 2008, with Master of Science in Nursing dual program specialized in Acute Care Nurse Practitioner and Clinical Nurse Specialist. In 2010, she has joined UCLA Pfleger Liver Institute and Asian Liver Cancer Center working as an outpatient Nurse Practitioner specializing in liver diseases including viral hepatitis, hepatobiliary diseases, alcohol related liver diseases, Metabolic Dysfunction-Associated Steatotic Liver Disease/Steatohepatitis, autoimmune liver diseases, and hepatocellular carcinoma. Since 2016, she has been a guest lecturer at UCLA School of Nursing for Master Entry Clinical Nurse (MECN) and MSN Adult/Gero Acute Care program. She is also a preceptor for Adult/Gero Acute Care Program. She participated in Hepatitis C Screening in the Community Churches to promote awareness of hepatitis C and the importance of treatment of hepatitis C. She also participates in Patient Symposium at UCLA to give a lecture to update care of the liver transplant patients. She is also a faculty of Gastroenterology Hepatology Advanced Practice Provider (GHAPP) since 2018 and a speaker for both GHAPP National meeting and Regional GHAPP in Los Angeles. Since 2013, she has published total 14 research papers and case report including the most recent three are Recommendations for the Management of MASH by Advanced Practice Providers in the US, Clinicians and Patients Confront Practical Issues in Wilson Disease, and Overview of chronic Hepatitis B management.
MASLD/MASH Learning Center
Live From GHAPP National: Diagnosis and Management of PBC and PSC Tools Trials and Targets
November 2025
Learn how to confidently approach autoimmune cholestatic liver diseases in this high-yield talk from Ann Moore, NP, at Arizona Liver Health. She breaks down practical diagnosis and management of primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC)—from simple diagnostic algorithms (ALP, AMA, MRCP) and treatment goals like deep biochemical remission, to first- and second-line options with UDCA and newer agents such as FXR and PPAR agonists. Perfect for hepatology APPs and clinicians looking to optimize outcomes, manage pruritus and bone disease, and stay current on emerging trials and therapeutic targets in PBC and PSC.
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Live From GHAPP National: Abnormal Liver Imaging: What's Next?
November 2025
In this high-yield session, HoChong Gilles, NP from the Central Virginia VA Healthcare System, guides viewers through a practical approach to abnormal liver imaging and the challenge of incidental liver lesions. She reviews how to differentiate cystic versus solid liver lesions, outline key risk factors, and interpret enhancement patterns on ultrasound, CT, and MRI to distinguish benign findings—such as simple cysts, hemangiomas, FNH, and hepatic adenomas—from malignant lesions including hepatocellular carcinoma (HCC) and metastatic disease. Designed for APPs and clinicians who frequently encounter unexpected lesions on imaging, this concise overview provides clear strategies for knowing when to reassure, when to monitor, and when to escalate evaluation or referral.
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Live From GHAPP National: Drug Induced Liver Injury
November 2025
In this high-yield session, Kate Lee-Young, DNP from Johns Hopkins, provides a clear and practical overview of drug-induced liver injury (DILI)—the most common cause of acute liver failure in the U.S. She reviews how DILI happens, common offending agents (including acetaminophen, antibiotics, anti-tubercular drugs, and herbal supplements like ashwagandha), key clinical patterns of injury, and how to diagnose DILI using history, labs, imaging, and R-value classification. Viewers will learn when to suspect DILI, how to rule out other liver diseases, when biopsy is useful, and essential steps in management including drug discontinuation, supportive care, NAC use, and prevention strategies. A concise, evidence-based guide for hepatology APPs and clinicians navigating suspected drug-related liver injury.
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Alcohol and MASLD/MASH: Navigating the Complex Relationship
November 2025
In this insightful session from the GHAPP MASLD Community Network, Alison Moe, PA-C, dives into the complex and often misunderstood relationship between alcohol use and metabolic dysfunction–associated steatotic liver disease (MASLD). Drawing from clinical experience, Alison explains why accurately screening, quantifying, and discussing alcohol consumption with patients is essential to understanding disease progression, treatment eligibility, and overall liver health. She outlines how continued alcohol use can alter liver function tests (LFTs), confound noninvasive test results, and affect candidacy for emerging MASH pharmacotherapies. Viewers will learn how to approach sensitive conversations about drinking habits without stigma, interpret AASLD alcohol threshold guidelines, and apply effective counseling strategies for patients with combined alcohol-related and metabolic liver disease. Alison also discusses the role of PEth urine testing, lifestyle counseling, and the importance of complete abstinence for those with advanced fibrosis. This educational talk provides clinicians with actionable insights to support patients in improving their metabolic and liver health through honest communication, behavioral change, and evidence-based management.
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NITs: A Practical Overview: Navigating the Basics
November 2025
Learn how non-invasive testing (NITs) is transforming fibrosis assessment in patients with MASLD and MASH. In this educational talk, Sarah Dawkins, NP, from Duke University Liver Clinic, breaks down the differences between simple steatosis (MASLD) and steatohepatitis (MASH), explains when and how to use serum-based tests like FIB-4 and ELF, and explores the advantages and limitations of imaging tests such as FibroScan and MRI elastography. Discover how to interpret results, avoid false positives, and determine when hepatology referral or biopsy is needed. Perfect for clinicians managing metabolic liver disease and looking to integrate non-invasive testing into everyday practice.
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Motivational Interviewing: Practical Techniques For Lifestyle Adherence
November 2025
In this engaging session from the GHAPP MASLD Community Network, Erin Tanner, DNP, from Gastro Health in Birmingham, Alabama, discusses how motivational interviewing can empower patients with fatty liver disease to make meaningful lifestyle changes. Drawing from over 14 years of experience in hepatology and gastroenterology, Erin explains how a collaborative, patient-centered approach can improve adherence to diet, exercise, and weight management plans. Using the RULE framework—Resist the righting reflex, Understand motivation, Listen with empathy, and Empower the patient—she demonstrates practical ways to foster trust and promote behavior change without judgment. Erin also introduces the SMART goals method (Specific, Measurable, Achievable, Relevant, Time-bound), guiding clinicians on how to set realistic, personalized goals that patients can achieve and sustain. Through reflective listening, affirmation, and consistent follow-up, providers can help patients overcome ambivalence, build confidence, and stay motivated on their journey to better liver and metabolic health.
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Diagnostic Workup: What Tests and When?
November 2025
In this educational session from the GHAPP MASLD Community Network, Erin Parkinson, APRN, from the Transplant Institute at Tampa General Medical Group, provides a detailed walkthrough of the diagnostic workup for metabolic dysfunction–associated steatotic liver disease (MASLD) and metabolic dysfunction–associated steatohepatitis (MASH). With experience in both general and transplant hepatology, Erin explains how to identify and evaluate patients at risk—beginning with key metabolic risk factors such as obesity, diabetes, and hypertension, and moving through the essential steps of imaging, laboratory testing, and fibrosis assessment. Viewers will learn when and how to use tools like ultrasound, FIB-4, FibroScan, ELF testing, and MR elastography to differentiate mild disease from advanced fibrosis or cirrhosis. Erin also emphasizes the importance of quantifying alcohol intake, ruling out viral, autoimmune, and genetic liver diseases, and applying risk stratification to determine appropriate follow-up and hepatology referral. This comprehensive overview equips APPs and clinicians with the practical framework needed to confidently diagnose, stage, and monitor MASLD and MASH, while incorporating HCC screening and long-term management strategies for high-risk patients.
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MASH/MASLD in Type 2 Diabetes: Concurrent Medication Management
November 2025
In this in-depth educational discussion from the GHAPP MASLD Community Network, Allysa Saggese, NP, from Weill Cornell Medicine in New York City, explores the critical intersection between type 2 diabetes, metabolic dysfunction–associated steatotic liver disease (MASLD), and metabolic dysfunction–associated steatohepatitis (MASH). Allysa explains why patients with diabetes are at higher risk for developing MASH and advanced fibrosis, detailing how insulin resistance, excess glucose, and fat accumulation drive inflammation and liver damage. She reviews the most common diabetes medication classes—including metformin, GLP-1 receptor agonists, SGLT2 inhibitors, TZDs (pioglitazone), and DPP-4 inhibitors—and discusses their impact on liver fat, inflammation, and fibrosis, highlighting which options offer the most dual benefit for both glycemic and liver health. Viewers will learn how to approach medication selection and sequencing, when to use caution in cirrhosis or decompensated liver disease, and how to tailor treatment to each patient’s metabolic profile. With clear clinical reasoning and practical insights, Allysa provides a concise roadmap for optimizing diabetes management in patients with MASLD and MASH—balancing glycemic control, liver protection, and overall metabolic wellness.
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LFTs Demystified: A Practical Guide for APPs
November 2025
In this episode of Liver Functions Demystified, Chantil Jeffreys, FNP from Gastro One in Memphis, Tennessee, shares a practical guide for interpreting liver enzyme results and identifying when to evaluate patients for MASLD (metabolic dysfunction–associated steatotic liver disease) and MASH (metabolic dysfunction–associated steatohepatitis). Drawing from 24 years of clinical experience, she explains how to recognize key patterns such as persistent ALT and AST elevations, the significance of ALT being higher than AST in early MASH, and why associated metabolic risk factors—like type 2 diabetes, obesity, hypertension, and hyperlipidemia—make even mild elevations clinically important. Chantil also reviews the role of other markers including GGT, alkaline phosphatase, bilirubin, albumin, and INR in assessing disease severity and progression. She highlights how to differentiate MASH from alcohol-associated liver disease, viral hepatitis, and drug-induced liver injury, and underscores the importance of serial monitoring to track improvement or progression. This video offers a clear, practical framework for clinicians, APPs, and primary care providers to better evaluate and manage patients with liver disease in everyday practice.
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NITs: A Practical Overview: Navigating the Basics
November 2025
Join Renee Pozza, a hepatology nurse practitioner with more than 25 years of experience, as she breaks down the essentials of non-invasive testing and fibrosis assessment in patients with metabolic-associated steatotic liver disease (MASLD) and metabolic-associated steatohepatitis (MASH). In this educational session, Renee reviews how to identify patients early, interpret key laboratory scores such as FIB-4 and ELF, and apply imaging tools like FibroScan® and MRE to evaluate liver fat and fibrosis. Learn how to distinguish simple steatosis from progressive fibrosis, recognize markers of advanced liver disease, and integrate non-invasive tests into clinical workflows across primary care, GI, endocrinology, and hepatology settings. Renee also highlights when to consider pharmacologic interventions—including resmetirom and GLP-1 therapies—and when to refer to hepatology for advanced fibrosis or cirrhosis. For more expert-led resources on MASLD, MASH, and liver health, visit the MASLD Community Network to access webinars, clinical insights, and continuing education for advanced practice providers.
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Diet and Nutrition: Tailoring Plans For Diverse Populations
October 2025
In this presentation, Tina Gregg, NP-C, from GI Associates, shares practical, evidence-based strategies for nutrition and lifestyle management in MASLD and MASH. With nearly two decades of experience caring for patients with liver disease, Tina emphasizes that lasting improvement requires more than telling patients to “lose weight”—it calls for tailored, culturally sensitive, and sustainable dietary guidance. She explores data supporting the Mediterranean diet, DASH diet, low- and moderate-carbohydrate approaches, intermittent fasting, and plant-based eating, detailing how each can reduce liver fat, improve insulin sensitivity, and decrease inflammation. Tina also discusses how to adapt these principles for patients’ cultural preferences, socioeconomic barriers, and comorbidities such as diabetes, CKD, and hyperlipidemia. This session, part of the GHAPP MASLD & MASH Community Network, highlights how APPs can guide patients toward realistic dietary changes that enhance both liver and metabolic health.
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NITs: A Practical Overview: Navigating the Basics
October 2025
In this informative session, Anna Marie Hefner, CPNP, a hepatology nurse practitioner at the Southern California Liver and GI Center, shares her 15+ years of experience managing patients with MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). She explains how her clinic has created a collaborative, patient-centered approach—hosting dedicated fatty liver clinics that foster education, peer support, and lifestyle discussion among patients. Anna Marie walks viewers through how to distinguish between simple steatosis and MASH, emphasizing that proper diagnosis drives appropriate management—from lifestyle counseling and diet modification for early stages to medication and specialist referral for advanced fibrosis or cirrhosis. She offers a detailed overview of non-invasive tests (NITs) such as FIB-4, ELF, FibroScan, and MRI elastography, outlining how each test is performed, how to interpret key cutoff values, and when to refer patients to hepatology. She also highlights the importance of evaluating comorbidities, including cardiovascular and metabolic risk factors, medication history, and family health background, as part of comprehensive liver assessment. Finally, she encourages providers to follow AASLD and EASL guidelines, utilize collaborative care across specialties, and engage with professional APP organizations like GHAPP to stay current on evolving best practices in fatty liver disease management.
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Alcohol and MASLD/MASH: Navigating the Complex Relationship
October 2025
In this insightful presentation, Marcella Pomeranz, DNP, lead nurse practitioner at Digestive Associates in Las Vegas, shares practical strategies for managing patients with alcohol use and MASLD. Drawing on her experience leading a team of 12 APPs, Marcella explains how to effectively screen for alcohol consumption, build trust and openness with patients, and use tools like the AUDIT-C and phosphatidylethanol (PEth) testing to accurately assess alcohol intake and monitor progress. She highlights the synergistic relationship between alcohol and metabolic dysfunction, emphasizing how even low to moderate alcohol use can accelerate liver injury, fibrosis, and the progression to cirrhosis or hepatocellular carcinoma. Marcella breaks down the biological mechanisms behind this interaction—oxidative stress, inflammation, mitochondrial dysfunction, and increased gut permeability—and provides evidence-based advice on lifestyle modification, structured support programs such as AA and addiction medicine referrals, and potential roles for GLP-1 therapies in managing both metabolic and behavioral aspects. She also discusses the importance of interpreting non-invasive tests (NITs) like FibroScan and serum markers in the context of recent alcohol use, using them as motivational tools to show patients measurable improvement. This session offers real-world clinical guidance for APPs, GI providers, and hepatology teams working to reduce risk and optimize care for patients with alcohol-associated MASLD and MASH.
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NITs: A Practical Overview: Navigating the Basics
October 2025
In this educational session, Tuesday Werner, DNP, from Mayo Clinic Arizona, provides an in-depth overview of non-invasive testing (NITs) and their critical role in the diagnosis and management of MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). With over 20 years of experience in hepatology, she breaks down the fundamental differences between simple steatosis (MASLD) and inflammatory steatohepatitis (MASH), explaining why identifying fibrosis risk through non-invasive methods—such as FIB-4, NFS, ELF, FibroScan (VCTE), and MRE—is essential for guiding patient management, referrals, and surveillance. Tuesday discusses the strengths and limitations of serum-based vs. imaging-based NITs, emphasizing their complementary roles in evaluating fibrosis and preventing unnecessary biopsies. She also outlines how to integrate NIT results with patient history, comorbidities, and liver function tests to determine monitoring intervals and hepatology referrals. Viewers will learn key thresholds and cutoff values for interpreting FIB-4 and liver stiffness measurements, helping to stratify patients into low-, moderate-, and high-risk categories for advanced fibrosis or cirrhosis. This session underscores how NITs are transforming liver care—allowing for early detection, better patient stratification, and proactive management of MASLD and MASH through evidence-based, non-invasive approaches.
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Monitoring for MASLD in Type 2 Diabetes
October 2025
In this educational session, Punam Punja, MMS, PA-C, from Emory Healthcare in Atlanta, discusses the crucial connection between type 2 diabetes and MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease). With over 15 years of hepatology experience, Punam outlines a practical, evidence-based approach for screening and monitoring patients with type 2 diabetes who are at risk for MASH (Metabolic Associated Steatohepatitis). She explains how the American Diabetes Association (ADA) now recommends routine fibrosis screening using the FIB-4 index, a simple, non-invasive calculation that helps identify patients at risk for advanced fibrosis — the strongest predictor of liver-related outcomes. Punam breaks down risk thresholds, screening intervals, and the role of secondary assessments such as transient elastography or ELF testing. She also emphasizes the importance of patient education, noting that unlike diabetic complications such as retinopathy, MASH is often silent but reversible with lifestyle modification. As October marks National Liver Awareness Month, Punam encourages APPs to make liver screening a standard part of diabetes care.
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PCP Screening for MASH/MASLD: Identifying At-Risk Patients
October 2025
In this educational video, Cheryl Walsh, ACNP-C, from GI Alliance in Arkansas, shares practical guidance on screening for MASH (Metabolic Associated Steatohepatitis) and MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) in the primary care setting. Drawing from over 15 years of experience in gastroenterology, Cheryl highlights how nurse practitioners and advanced practice providers can efficiently identify at-risk patients—particularly those with type 2 diabetes, obesity, or cardiometabolic risk factors such as hypertension and elevated triglycerides. She explains how simple, validated tools like the FIB-4 index and ELF score can be incorporated into routine labs to detect early signs of fibrosis and liver disease progression. Cheryl also discusses communicating positive results, setting appropriate follow-up intervals, and empowering patients through lifestyle modifications and diet counseling. By streamlining screening into busy primary care workflows, clinicians can play a vital role in early detection and prevention of advanced liver disease.
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NITs: A Practical Overview: Navigating the Basics
October 2025
In this educational session, Stacie Egan, NP, from Ogden Clinic Gastroenterology, explores the critical role of non-invasive testing (NITs) in diagnosing and managing MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). Stacy explains the key differences between MASLD—fat accumulation without active damage—and MASH, where inflammation and cellular injury drive fibrosis, cirrhosis, and hepatocellular carcinoma. Understanding this distinction is vital for early detection and intervention. This session also highlights how ALT levels, metabolic comorbidities, and alcohol use should influence decision-making, and why combining test results with clinical context ensures accurate risk stratification. Clinicians will learn how to use NITs not as standalone diagnostics, but as integrated puzzle pieces that drive earlier treatment with lifestyle modification and emerging pharmacotherapies for F2–F3 fibrosis. Perfect for APPs, NPs, and GIs managing patients with fatty liver disease, this video offers a clear roadmap to detect, monitor, and manage MASH with fibrosis—improving outcomes while minimizing invasive procedures.
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Diet and Nutrition: Tailoring Plans for Diverse Populations
October 2025
In this episode, Allison Moser, NP, from Rush University Medical Center, dives into one of the most impactful aspects of MASH (Metabolic Dysfunction–Associated Steatohepatitis) management — diet and nutrition. While weight loss is often the starting point, Allison explains why sustainable liver health depends on personalized, culturally sensitive, and practical nutrition strategies. Learn how evidence-based eating patterns like the Mediterranean diet and plant-based diets can reduce hepatic steatosis, improve insulin sensitivity, and lower inflammation, even without weight loss. Allison shares actionable food swaps for diverse cultures, affordable ways to eat healthy when access is limited, and tailored recommendations for patients with comorbidities like diabetes, CKD, and cardiovascular disease. She also discusses the major role of added sugars, processed foods, and sugary or diet beverages in driving liver damage — and how to help patients make realistic, stepwise changes that last. Whether you’re an APP, NP, PA, or clinician treating patients with MASH or MASLD, this episode offers practical, evidence-based tools to improve nutrition counseling, build patient trust, and support long-term liver health.
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Pharmacotherapy for MASH/MASLD: An Overview
September 2025
In this expert discussion, Anne Moore, NP with Arizona Liver Health in Phoenix, shares key insights into the evolving landscape of pharmacotherapy for MASH and MASLD. She explains the primary histological endpoints that matter most in clinical trials—MASH resolution and fibrosis improvement—and why these markers are critical for both regulatory approval and long-term patient outcomes. Anne highlights the approval of resmetirom, the first FDA-approved treatment for MASH with F2–F3 fibrosis, and reviews how it works as a selective THR-beta agonist to reduce liver fat and inflammation while improving fibrosis. Drawing on Phase 3 trial data, she outlines its efficacy, safety profile, and side effects, as well as strategies for monitoring patients through non-invasive testing, liver chemistries, and metabolic risk factors. This session also explores which patients are most appropriate candidates for MASH pharmacotherapy, with a focus on those at high risk of progression but still early enough in their disease to benefit. For advanced practice providers and hepatology specialists, this video provides a clear, practical roadmap to identifying, treating, and monitoring patients with MASH in everyday clinical practice.
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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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MASH/MASLD in Type 2 Diabetes: Concurrent Medication Management
August 2025
In this video, April Morris, FNP, shares her expertise on the close connection between type 2 diabetes and fatty liver disease (MASLD/MASH). With over 16 years of experience in hepatology and endocrinology, she explains why patients with type 2 diabetes are at a higher risk of developing MASH due to shared risk factors like insulin resistance and obesity. April highlights how improving glycemic control, lowering A1C, weight loss, and lifestyle modifications can significantly reduce liver fat, inflammation, and fibrosis progression. She discusses the benefits of modern diabetes medications—including GLP-1 receptor agonists such as semaglutide and tirzepatide, SGLT2 inhibitors, and metformin—and how they not only improve blood sugar and weight management but also support liver, kidney, and heart health. Importantly, she notes that most diabetes medications remain safe for patients with liver disease unless advanced decompensated cirrhosis is present, where caution with metformin may be necessary due to lactic acidosis risk. April emphasizes that treating diabetes aggressively and reaching an A1C target around 7% can slow or even prevent progression of liver fibrosis. For APPs and providers, the takeaway is clear: effective diabetes management is one of the most powerful tools to improve liver outcomes.
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Motivational Interviewing: Practical Techniques for Lifestyle Adherence
July 2025
In this episode, Emily Przybyl, PA-C at Erie County Medical Center in Buffalo, NY, dives into the foundations of motivational interviewing for patients with MASLD (metabolic dysfunction-associated steatotic liver disease) and MASH. With practical, real-world insights from her clinical experience, Emily shares how providers can build trust, meet patients where they are, and guide them toward meaningful, sustainable lifestyle changes. She emphasizes asking open-ended questions, assessing social determinants of health like income and food access, and collaboratively developing realistic diet and exercise plans tailored to each patient’s circumstances. Emily also highlights culturally sensitive counseling techniques, strategies for overcoming barriers like limited mobility or unsafe environments, and the importance of setting SMART goals for weight loss and liver health. Whether patients are struggling with motivation, resistant to change, or unsure where to start, this episode provides a supportive, patient-centered framework for fostering long-term behavior change in metabolic liver disease.
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PCP Screening for MASH/MASLD: Identifying At-Risk Patients
August 2025
Join Tessa Janovsky, PA-C from Arizona Liver Health, for a practical and guideline-based discussion on screening for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH) in primary care. This session outlines which patient populations Advanced Practice Providers (APPs) should routinely screen—such as individuals with type 2 diabetes, medically complicated obesity, metabolic risk factors with fatty liver on imaging, moderate alcohol use (MetALD), or a family history of MASH cirrhosis. Learn how to apply first-line non-invasive screening tools like FIB-4 and the NAFLD Fibrosis Score, understand their limitations, and incorporate them into busy clinic workflows. Tessa shares strategies for communicating positive results to patients, next steps for further evaluation (ELF test, FibroScan, MRI elastography), and criteria for timely referral to gastroenterology or hepatology. With practical tips for integrating MASLD/MASH screening into electronic medical records, building clinical pathways, and standardizing protocols, this episode equips PCPs and specialists to detect high-risk patients earlier, intervene effectively, and ultimately improve liver health outcomes.
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Motivational Interviewing: Practical Techniques for Lifestyle Adherence
August 2025
Discover how motivational interviewing can transform the management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) by empowering patients to make sustainable lifestyle changes. In this session, we explore why lifestyle modification—particularly achieving 5–10% weight loss—is the most effective intervention for MASLD, yet often fails when approached through traditional “diet and exercise” advice alone. Learn the four core principles of motivational interviewing—expressing empathy, developing discrepancy, rolling with resistance, and supporting self-efficacy—and how to apply them in real-world clinical encounters to improve patient engagement and outcomes. Through practical strategies, sample dialogue, and a compelling patient case study, this discussion highlights how small, achievable changes in diet and physical activity can reduce hepatic inflammation, improve insulin resistance, and even reverse fibrosis. Whether you’re a hepatology provider, primary care clinician, or allied health professional, you’ll gain actionable tools to activate patient motivation, overcome barriers, and support lasting behavioral change in MASLD care.
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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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Addressing Health Disparities: Equity Considerations in MASH/MASLD Care
August 2025
Join Elizabeth Goacher, PA-C from Duke University Medical Center, for an in-depth discussion on addressing healthcare disparities in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). As part of the MASLD Community Network, supported by Madrigal, Elizabeth explores how social determinants of health—including race, ethnicity, socioeconomic status, geography, and access to nutritious food—impact MASLD prevalence and outcomes. She highlights the higher rates of MASLD in Hispanic populations, individuals with obesity, diabetes, cardiovascular disease, and hypertension, and emphasizes actionable strategies clinicians can use in everyday practice to mitigate bias, improve screening, and provide equitable care. This episode underscores the importance of starting with the individual patient, asking the right questions, and tailoring recommendations based on access and resources to help reduce disparities and improve liver and metabolic health.
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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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LFTs Demystified: A Practical Guide for APPs
August 2025
Join Maly Tiev, NP at NYU Langone Health, for this essential educational session on demystifying liver function tests (LFTs), brought to you by the GHAPP MASLD Community Network. In this video, Maly explains how to interpret ALT, AST, alkaline phosphatase, GGT, bilirubin, albumin, INR, and platelet counts in the context of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) and MASH (Metabolic Steatohepatitis). Learn why elevated liver enzymes are not always present in MASH, how to distinguish between different causes of abnormal LFTs—including alcohol-related liver disease, viral hepatitis, and drug-induced liver injury—and how serial LFT monitoring can indicate treatment response or disease progression. Discover the importance of using non-invasive tools for fibrosis risk stratification, the role of platelets as a key marker, and how a deeper understanding of synthetic function tests can help identify cirrhosis earlier. Whether you're a clinician or a patient looking to understand the lab work behind fatty liver disease, this presentation offers practical insights for interpreting LFTs with confidence.
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Liver Model Overview
July 2025
Join Alison Moe, PA-C with United Digestive, as she walks through a hands-on demonstration using a life-sized liver model to help patients better understand fibrosis and liver disease progression. In this engaging and practical overview, Allison explains how different stages of liver fibrosis—from normal liver to cirrhosis and hepatocellular carcinoma—can be felt and visualized using a segmented anatomical model. She shares how this tool enhances patient education during discussions about non-invasive liver testing, such as FibroScan, CAP scores, FIB-4, ELF testing, and more. Designed to support visual learners and improve comprehension of disease state, this video is a valuable resource for clinicians and patients navigating the complexities of metabolic-associated fatty liver disease (MASLD) and its progression to MASH. Learn how tactile and visual teaching aids can bridge the gap between diagnostics and patient understanding in hepatology care.
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MASLD Pharmacotherapy With Jordan Mayberry
July 2025
Join Jordan Mayberry, MPAS, PA-C from UT Southwestern, for an insightful session from the GHAPP MASLD/MASH Community Network focused on the evolving landscape of pharmacotherapy in MASLD and MASH. This presentation explores evidence-based strategies for treating metabolic dysfunction–associated steatotic liver disease (MASLD), with an emphasis on weight loss, diabetes management, and liver-directed therapies. Jordan breaks down key data on GLP-1 receptor agonists, SGLT2 inhibitors, Vitamin E, pioglitazone, and highlights the latest clinical evidence supporting the use of Resmetirom—the first FDA-approved treatment for MASH with stage 2 or 3 fibrosis. Learn how these therapies fit into hepatology practice, including clinical considerations, side effect management, and patient selection. Stay up to date on ongoing research, treatment duration, and real-world application of these new therapies. Don’t forget to register and join the GHAPP MASLD/MASH Community Network for continued education and access to valuable resources.
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Discordant NITs, the Gray Zone
June 2025
In this episode, Gabriella McCarty, NP-C at Oshi Health, shares her deep clinical insights on the evolving landscape of MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). With over 26 years of experience in private practice, Gabriella explains that the majority of fatty liver cases she encounters are found incidentally—often during evaluations for unrelated GI issues like GERD or routine colon screenings. She discusses the updated nomenclature from NAFLD to MASLD and outlines the cardiometabolic risk factors that inform diagnosis, such as obesity, diabetes, hypertension, and dyslipidemia. Gabriella emphasizes the importance of non-invasive assessments like FibroScan, FIB-4, ELF testing, and, in select cases, liver biopsy or MR elastography for accurate fibrosis staging. She also highlights the challenges of discordant test results and shares practical strategies for follow-up and monitoring. With a strong focus on lifestyle modification—promoting a Mediterranean diet, targeted weight loss, regular exercise, and alcohol avoidance—this episode provides essential education for providers managing patients with fatty liver disease, even when it's not the primary reason for the visit.
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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.
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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.
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Non-Invasive Testing With Jordan Mayberry
July 2025
In this educational session, Jordan Mayberry, PA-C from UT Southwestern, presents a practical overview of non-invasive testing for diagnosing and staging metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic-associated steatohepatitis (MASH). Using a real-world patient case, Jordan discusses how clinicians can leverage key tools—such as FIB-4, ELF testing, FibroScan (VCTE), and MRI elastography—to assess fibrosis and stratify risk in patients with MASLD. She explains the benefits, limitations, and clinical applications of each modality, including guidance on when and how to use them in everyday practice. Whether you're a hepatology specialist or a provider managing patients with cardiometabolic risk factors, this talk delivers a clear, step-by-step approach to incorporating non-invasive liver assessment into your workflow. Viewers are also invited to explore the GHAPP MASLD/MASH Community Network for ongoing education, resources, and clinical insights.
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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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APP Insight: Common Questions from Patients About MASH
June 2025
In this episode, Jordan Mayberry, MPAS, PA-C, a seasoned hepatology provider at UT Southwestern in Dallas, Texas, addresses some of the most frequently asked questions from patients diagnosed with MASLD (Metabolic Dysfunction–Associated Steatotic Liver Disease) and MASH (Metabolic Dysfunction–Associated Steatohepatitis). With over 12 years of clinical experience, Jordan explains the root causes of MASLD/MASH, including key cardiometabolic risk factors like obesity, diabetes, hypertension, and hyperlipidemia, as well as genetic predispositions—particularly in Hispanic populations. He emphasizes the importance of fibrosis assessment in guiding treatment decisions, explaining that patients with early-stage disease should focus on lifestyle changes, while those with more advanced fibrosis (stages F2–F3) may be candidates for pharmacologic therapy such as resmetirom (Rezdiffra). Jordan also explores how prognosis depends on fibrosis stage and long-term management of comorbidities, making early intervention and risk stratification essential. This episode offers practical insights for clinicians aiming to improve conversations and care strategies for patients living with MASLD or MASH.
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NITs: A Practical Overview: Navigating the Basics
July 2025
In this practical and engaging overview, Janet Gripshover, nurse practitioner and nurse manager for the Cedars-Sinai Liver Transplant Program, breaks down the essentials of non-invasive testing (NITs) for assessing fibrosis in patients with metabolic-associated steatotic liver disease (MASLD). She explains the critical distinction between MASLD and MASH (metabolic-associated steatohepatitis), highlighting why early identification of aggressive liver disease is essential—even in patients without cirrhosis. Janet reviews key NIT tools, including FibroScan, MR elastography, and serum biomarkers like FIB-4 and ELF score, providing clinical insights on interpreting results, integrating them into risk stratification, and tailoring next steps for patient care. Viewers will learn when to act on elevated liver stiffness, how to interpret CAP scores, and why weight loss and comorbidity control remain foundational treatments. Whether you're new to hepatology or seeking a refresher on navigating fibrosis assessments, this video offers a clear, actionable framework to help prevent disease progression and optimize outcomes for patients with fatty liver disease.
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GHAPPcast: Recognizing the Severity of MASH
January 2025
Thank you to Madrigal for sponsoring this episode of GHAPPcast. In this episode of GHAPPcast, nurse practitioners Patrick Horne and April Morris from discuss the complexities of identifying and managing patients with metabolic-associated steatohepatitis (MASH). They explore clinical approaches, including the use of bloodwork, family history, and advanced diagnostic tools such as FibroScan, to recognize patients at risk. Patrick and April emphasize the importance of lifestyle interventions like diet and exercise alongside new medical therapies, while also offering practical tips for clinicians on patient monitoring and treatment management. Tune in for valuable insights into managing MASH in clinical practice.
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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.
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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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Monitoring for MASLD in Type 2 Diabetes
July 2025
In this episode, Kelly Smeester, PA-C from South Denver Gastroenterology, explores the critical intersection of type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD). Drawing from her background in both hepatology and endocrinology, Kelly offers practical, evidence-based strategies for non-invasive monitoring of liver fibrosis in patients with diabetes who may initially appear low risk. She highlights the utility of tools like FIB-4, ELF score, FibroScan, and MR elastography, while emphasizing the limitations of relying solely on liver function tests (LFTs). Kelly recommends annual FIB-4 screening—easily calculated with existing lab values—and discusses when to escalate to more advanced diagnostics. She also shares how advanced practice providers (APPs) can seamlessly integrate MASH education, lifestyle counseling, and routine screening into the diabetes care workflow, supporting early intervention and long-term liver health. This episode is a must-listen for clinicians looking to optimize care for patients at risk of silent liver disease progression in the setting of metabolic co-morbidities.
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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.
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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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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.
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Monitoring for MASLD in Type 2 Diabetes
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.
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Role of Exercise in Liver Health
June 2025
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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Addressing Health Disparities: Equity Considerations in MASH/MASLD Care
July 2025
In this powerful and timely episode, Robin Soto, FNP at UC San Diego Health, explores the deep-rooted health disparities impacting patients with MASH (metabolic dysfunction-associated steatohepatitis) and MASLD (metabolic dysfunction-associated steatotic liver disease). With a focus on equity in liver care, Robin highlights the disproportionate burden of disease in Hispanic and underserved populations and the complex interplay of genetics, socioeconomic status, healthcare access, and systemic bias that drives these outcomes. She shares actionable strategies for advanced practice providers (APPs) to implement culturally sensitive communication, bias-conscious screening protocols using tools like FIB-4, NAFLD fibrosis score, and transient elastography, and how to leverage telehealth and community partnerships to bridge gaps in care. Robin also addresses the importance of culturally relevant dietary counseling, inclusive family engagement, and motivational interviewing to enhance adherence and improve long-term outcomes. Whether you're in primary care, hepatology, or community health, this episode offers a roadmap to advance health equity in the management of fatty liver disease.
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NITs: A Practical Overview: Navigating the Basics
July 2025
Join Ellie Gonyeau, a nurse practitioner at Beth Israel in Boston, for an insightful podcast episode on metabolic dysfunction-associated steatotic liver disease (MASLD) and MASH, and how to effectively use non-invasive testing (NITs) to evaluate and manage patients with fatty liver disease. Ellie breaks down the differences between MASLD and MASH—explaining why distinguishing simple steatosis from inflammatory liver injury matters for long-term outcomes. She covers first-line serum-based tools like FIB-4 and ELF score, as well as imaging-based modalities including FibroScan and MR elastography, helping clinicians understand when and how to apply each test. With practical tips on interpreting fibrosis risk thresholds, stratifying patients with metabolic comorbidities, and educating primary care teams, this episode emphasizes the power of early identification, appropriate triage, and collaborative care to prevent disease progression. Whether you're working in general GI, primary care, or hepatology, this episode equips you with tools to make liver disease detection more proactive and patient-centered.
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NITs: A Practical Overview: Navigating the Basics
July 2025
In this episode, Christie Morrison breaks down the fundamentals of non-invasive testing (NITs) for evaluating patients with fatty liver disease, including MASLD and MASH. She explains the key differences between steatosis (MASLD) and steatohepatitis (MASH), highlighting how non-invasive tests can replace liver biopsy for staging fibrosis. Christy reviews common tools like FIB-4, NAFLD fibrosis score, Enhanced Liver Fibrosis (ELF) score, transient elastography (FibroScan), and MR elastography, and outlines how to choose the right test based on patient factors such as co-morbidities, geography, access to labs, and imaging availability. The episode also emphasizes the importance of fibrosis risk stratification, interpreting FIB-4 cutoffs, and monitoring liver stiffness or ELF scores after initiating lifestyle or pharmacologic treatment—including newer therapies like resmetirom. This is a must-watch for APPs, GI clinicians, and primary care providers seeking to improve care pathways and outcomes in patients with metabolic liver disease through practical, accessible strategies for fibrosis detection and management.
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Alcohol and MASLD/MASH: Navigating the Complex Relationship
June 2025
In this powerful and highly educational episode, Scott Springer, PA-C at Erie County Medical Center in Buffalo, NY, explores the complex and often overlooked relationship between alcohol use and metabolic dysfunction–associated steatotic liver disease (MASLD/MASH). Drawing from his dual expertise in hepatology and addiction medicine, Scott outlines the importance of accurately assessing alcohol use when diagnosing MASLD, MASH, MetALD, or ALD—emphasizing that MASLD and MASH are diagnoses of exclusion and heavily influenced by alcohol consumption thresholds. He discusses best practices for screening, including patient-centered, nonjudgmental interviewing, the use of biomarkers like PEth and urine ethyl glucuronide, and how these tools enhance accuracy and accountability in care. Scott reviews national guidelines that recommend alcohol abstinence for patients with chronic liver disease and presents data showing how even small reductions in alcohol use can significantly lower the risk of cirrhosis. He also unpacks the challenges of interpreting liver tests in patients with ongoing alcohol use, the limitations of non-invasive testing like FibroScan and FIB-4, and how alcohol may disqualify patients from emerging pharmacotherapy such as resmetirom. Finally, he highlights the promising potential of GLP-1 medications in managing both liver fibrosis and alcohol use. This episode is essential listening for hepatology providers, addiction specialists, and any clinician involved in the care of patients with coexisting liver disease and substance use disorders.
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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.
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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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Viral Hepatitis and MASH/MASLD: Understanding the Connection
June 2025
In this episode, Patrick Horne, NP from the University of Florida, explores the important connection between viral hepatitis and MASLD/MASH (Metabolic Dysfunction–Associated Steatotic Liver Disease/Steatohepatitis). While patients may present with a presumed diagnosis of MASLD or MASH, Patrick emphasizes the critical need to rule out coexisting liver diseases such as hepatitis B and C. The presence of both metabolic and viral liver diseases can significantly accelerate liver inflammation, fibrosis progression, and ultimately cirrhosis—a concept he explains using the “two-hit” or even “three-hit” theory. Patrick walks through the recommended screening protocols, including one-time HCV testing for all adults over 18 and complete HBV panels to assess for immunity, past exposure, and chronic infection. He stresses that treating viral hepatitis—especially with today's highly effective antivirals—can and should occur alongside lifestyle modification strategies for MASLD/MASH. He also discusses how liver stiffness measurements can be skewed by active inflammation and suggests reassessing fibrosis after treating viral hepatitis. This episode is a must-watch for providers managing patients with liver disease, highlighting the need for a comprehensive, layered diagnostic approach.
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HCC Surveillance: Implementation in Patients with Advanced Fibrosis/Cirrhosis from MASH
July 2025
In this expert-led session, Elizabeth Alqueza, PA-C, from Beth Israel Deaconess Medical Center in Boston, discusses the critical importance of hepatocellular carcinoma (HCC) surveillance in patients with steatotic liver disease, including MASLD and MASH. HCC is a leading cause of cancer-related death worldwide, and early detection is vital for improving survival outcomes. Using a real-world case study, Elizabeth highlights risk factors such as obesity, type 2 diabetes, and advanced fibrosis—and underscores the growing role of MASH in HCC development, even in the absence of cirrhosis. She outlines best practices for staging, the importance of early referral to hepatology, and AASLD-recommended surveillance protocols using ultrasound and AFP testing every 6 months. The video also explores systemic barriers to screening and actionable strategies to improve adherence, such as EMR alerts, streamlined imaging protocols, and improved coordination between primary care and hepatology. This presentation is essential viewing for healthcare professionals managing patients with liver disease, offering practical tools to enhance HCC detection and optimize long-term outcomes.
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Alcohol and MASLD/MASH: Navigating the Complex Relationship
July 2025
In this insightful video, Jordan Mayberry, a seasoned physician assistant at UT Southwestern in Dallas, explores the complex intersection of alcohol use and metabolic-associated steatotic liver disease (MASLD), including its progressive form, MASH. With over 12 years of hepatology experience, Jordan breaks down why accurate assessment of alcohol intake is essential—not just for diagnosis but for guiding patient management. Learn how to use motivational interviewing techniques to respectfully screen for alcohol use, quantify intake effectively, and differentiate between MASLD, MASH, and the emerging diagnosis of MetALD (metabolic dysfunction-associated alcoholic liver disease). Jordan also shares practical tips on managing patients with MASH who drink above recommended thresholds, including behavioral interventions, medications like acamprosate, and referral pathways such as SMART Recovery or addiction psychiatry. The video also highlights how ongoing alcohol use can skew liver function tests (LFTs), distort non-invasive testing (NIT) results like FibroScan or MRE, and potentially affect eligibility for future MASH pharmacotherapies. This session is a must-watch for clinicians aiming to provide holistic, evidence-based care to patients navigating the dual challenges of liver disease and alcohol use.
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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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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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PCP Screening for MASH/MASLD: Identifying At-Risk Patients
July 2025
In this essential FAQ video, Jennifer Geremia, PA-C, a seasoned gastroenterology provider practicing in Boston, outlines current primary care screening guidelines for identifying patients at risk for metabolic dysfunction-associated steatohepatitis (MASH) and MASLD. With nearly two decades of experience caring for GI and liver patients, Jennifer emphasizes the importance of integrating liver health into routine health maintenance—particularly for individuals with type 2 diabetes, obesity, metabolic syndrome, and related conditions. She reviews practical steps for risk stratification, beginning with FIB-4 scoring using readily available labs, and discusses how to interpret and act on the results, including when to refer for further testing like elastography or ELF testing. Viewers will also gain insight into patient counseling strategies, alcohol intake guidance, and the urgency of acting early—even in asymptomatic patients. This video is a must-watch for primary care clinicians aiming to improve detection and management of MASH and MASLD through evidence-based screening and timely intervention.
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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.
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Discordant NITs, the Gray Zone
July 2025
Join Lindsay Pratt, PA-C, from the University of Colorado School of Medicine’s Hepatology and Liver Transplant Department, as she unpacks the challenges of interpreting discordant results between non-invasive liver testing tools such as FIB-4 and FibroScan in patients with MASLD and MASH. With over 15 years of clinical experience, Lindsay walks viewers through how age, transaminase levels, platelet count, and patient factors like BMI and fasting status can impact test accuracy and reliability. She emphasizes when to consider advanced diagnostics like MRI elastography (MRE) or liver biopsy, and how to tailor decisions to the individual patient, especially when results don't align. This practical session is ideal for hepatology and GI providers navigating complex liver disease management, and includes tips for communicating test limitations and next steps with patients. Learn how to make informed decisions using non-invasive tests while maintaining patient-centered care in the management of fatty liver disease.
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Differentiating Between F3 and F4
July 2025
In this comprehensive discussion, HoChong Gilles, a nurse practitioner with 25 years of hepatology experience at the Richmond VA Medical Center, explores the critical importance of accurately distinguishing between F3 (advanced fibrosis) and F4 (cirrhosis) in patients with MASH (metabolic-associated steatohepatitis). While both stages carry increased risks of liver-specific and overall mortality, Gilles explains that F3 may still be reversible with lifestyle changes or pharmacotherapy, whereas F4 signals irreversible liver damage with heightened risk of complications like portal hypertension, hepatic encephalopathy, and liver cancer. Viewers will gain a deeper understanding of how non-invasive tests—like FIB-4, ELF, FibroScan, and MRE—perform in identifying fibrosis stage, including their limitations and overlaps. Gilles also outlines when to consider liver biopsy, especially in cases with discordant test results, atypical features, or clinical uncertainty. This video emphasizes how staging accuracy informs eligibility for therapies, surveillance strategies like HCC screening, and overall prognosis. Learn how to approach this nuanced distinction in clinical practice and why F3 vs. F4 isn't just semantics—it's a turning point in patient care.
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HCC Surveillance: Implementation in Patients With Advanced Fibrosis/Cirrhosis From MASH
July 2025
Learn when and how to effectively screen for hepatocellular carcinoma (HCC) in patients at risk, especially those with metabolic dysfunction-associated steatotic liver disease (MASLD). In this informative video, Maribeth Capuno, an adult nurse practitioner at the Richmond Veterans Affairs Medical Center, shares her clinical approach to early HCC surveillance. While AASLD guidelines recommend screening only after cirrhosis has been diagnosed, Maribeth highlights the growing evidence that patients with stage 3 fibrosis can still develop liver cancer—and why she begins surveillance earlier. She discusses the recommended tools, including liver ultrasound every six months and alpha-fetoprotein testing, and explores practical workflow tips to ensure patients remain adherent. Learn how imaging modalities like MRI and CT with liver protocol, along with tools like LI-RADS and tumor board consultations, contribute to timely and accurate diagnosis. The video also emphasizes key risk factors—such as obesity, diabetes, viral hepatitis, and lifestyle behaviors—and how managing these can help prevent the progression to HCC.
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Addressing Health Disparities: Equity Considerations in MASH/MASLD Care
July 2025
In this episode, Patrick Horne, NP at the University of Florida (UF Health), explores the impact of health disparities and socioeconomic inequality on the diagnosis and management of MASH (metabolic-associated steatohepatitis) and MASLD (metabolic dysfunction-associated steatotic liver disease). With a focus on rural and underserved populations, Patrick discusses how limited access to quality healthcare, healthy food, exercise options, and non-invasive testing (NITs) like FibroScan or MRI elastography can delay diagnosis and worsen outcomes. He shares practical, empathetic strategies for individualizing care, such as using accessible tools like FIB-4 or APRI, promoting low-cost physical activity like walking or swimming, and providing culturally sensitive nutrition advice tailored to financial and geographic realities. Patrick emphasizes the provider’s role as a patient advocate and coach, helping patients navigate barriers and create sustainable lifestyle modifications. This episode offers key insights for clinicians working to close gaps in care and promote equity in liver disease management.
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Pharmacotherapy Review
July 2025
Join Christina Hanson, FNP-C, from South Denver Gastroenterology, as she provides an in-depth overview of the current pharmacologic treatment landscape for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH). This expert-led session explores the three cornerstones of MASH management—lifestyle and weight loss interventions, cardiovascular risk reduction, and liver-directed therapy—while highlighting the evolving role of GLP-1 receptor agonists and the recent FDA approval of resmetirom, the first medication indicated for adults with MASH and moderate to advanced fibrosis. Christina also discusses clinical trial data from MAESTRO-NASH, reviews historical agents like vitamin E and pioglitazone, and offers practical guidance on patient selection, safety considerations, and monitoring strategies. Whether you’re a GI provider, hepatology specialist, or primary care clinician managing fatty liver disease, this video provides valuable insights into how emerging therapies are shaping the future of MASH treatment.
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Pharmacotherapy for MASH/MASLD: An Overview
June 2025
In this comprehensive episode, Christina Hanson, FNP-C at South Denver GI, provides an in-depth overview of pharmacotherapy for MASLD and MASH, with a focus on the FDA-approved therapy resmetirom (brand name Rezdiffra). Drawing on over 18 years of experience in hepatology and GI care, Christina explains the histologic endpoints used in clinical trials—MASH resolution and fibrosis improvement without worsening disease—and how they guided the approval of resmetirom. She breaks down the drug’s mechanism of action as a selective thyroid hormone receptor beta (THR-β) agonist, which promotes lipid metabolism and reduces liver inflammation without systemic toxicity. Christina reviews key Phase 3 data from the MAESTRO-NASH trial, showing resmetirom’s significant impact on both MASH resolution and fibrosis regression across diverse patient populations. She also outlines criteria for appropriate patient selection (those with stage F2-F3 fibrosis), clinical monitoring strategies, and management of side effects like transient GI discomfort. Christina emphasizes the importance of baseline screening for liver disease, autoimmune conditions, thyroid function, and lipid levels before initiating therapy. She highlights best practices from the 2024 AASLD guidelines for ongoing monitoring and treatment response assessment, including ALT and liver stiffness thresholds that help determine whether to continue or discontinue therapy. This episode is a must-watch for hepatology clinicians looking to implement evidence-based, patient-centered strategies in the management of MASH.
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Latest News & Blogs
Evaluation of a novel albumin platelet product (APP) fibrosis index and three non-invasive fibrosis indices in metabolic dysfunction-associated steatotic liver disease
November 2025
CONCLUSION: APP outperformed FIB4 in detecting cirrhosis or advanced fibrosis among patients with DM and was comparable in non-DM patients. Revised FIB-4 thresholds may be needed in MASLD/MASH patients with DM to improve its diagnostic accuracy.
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Inhibiting peripheral serotonin activates liver AMPK and reduces monocyte-derived macrophages and fibrosis
November 2025
Monocyte-derived liver macrophages are critical in the pathogenesis of metabolic dysfunction-associated steatohepatitis (MASH) and liver fibrosis, but their recruitment mechanisms remain unclear. Serotonin (5-hydroxytryptamine [5HT]) is a conserved monoamine synthesized by tryptophan hydroxylase 1 (Tph1) in peripheral tissues and Tph2 in the brain. We show that, in mice housed at thermoneutrality and fed a high-fat, high-fructose diet, inhibition of peripheral serotonin (pe5HT) through genetic...
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Tetrahedral Framework Nucleic Acid-Based Delivery of miR-34a Inhibitor for the Treatment of Metabolic Dysfunction-Associated Steatohepatitis
November 2025
Metabolic dysfunction-associated steatohepatitis (MASH), a metabolic liver disorder with severe complications, features hepatic inflammation and oxidative stress. MiR-34a dysregulation is a critical contributor to MASH progression, making it a promising therapeutic target. However, clinical translation of miR-34a-targeted interventions remains limited by poor stability and cellular uptake. Here, we developed a miRNA-binding tetrahedral framework nucleic acids (TDN)-based system, termed Tm to...
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Clinical trial: A Phase 2 Randomised Platform Study to Assess Monotherapy and Combination Treatment Regimens in Metabolic Dysfunction-Associated Steatohepatitis
November 2025
CONCLUSIONS: LYS006 20 mg bid monotherapy and LYS006 20 mg bid+tropifexor 200 μg qd therapy were well tolerated with the exception of a high frequency of pruritus in the combination arm, consistent with the now known pharmacologic effect of farnesoid X receptor agonists. The greater reductions in ALT and liver fat in the combination arm versus monotherapy arm were similar to those observed with tropifexor as monotherapy in a previously reported phase 2 clinical trial, and clear additional...
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Novel Aurone Derivative Ameliorates MASH Lipid Metabolism via the AMPK-ACC-PPARalpha Axis
November 2025
Metabolic dysfunction-associated steatohepatitis (MASH), a progressive form of metabolic dysfunction-associated fatty liver disease (MASLD), is characterized by disrupted lipid metabolism and persistent inflammation, which can lead to cirrhosis and hepatocellular carcinoma. The novel pan-peroxisome proliferator-activated receptor (PPAR) agonist 1d has been previously shown to alleviate insulin resistance and hepatic steatosis in type 2 diabetic (T2DM) mice; however, its mechanism of action...
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Farnesoid X Receptor Agonist INT-787 Inhibits Hepatic Mitochondrial Dysfunction in a Diet-Induced ob/ob Mouse Model of MASH
November 2025
This study evaluated the protective role of farnesoid-X-receptor (FXR) agonist INT-787 in the control of mitochondrial changes using a metabolic dysfunction-associated steatohepatitis (MASH) model. Lep-ob/ob mice were fed a control diet (CD) for 21 weeks (wks), or a high-fat diet (HFD) for 9 or 21 wks; in the 21 wk HFD groups, INT-787 (30 mg/kg/day) dosed via HFD admixture was added. The hepatic ATP, ROS, GSH and MIC19, which stabilizes the structure of inner mitochondrial membrane (IMM), were...
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Low-Abundance Proteomics Reveal Pleiotrophin and Fibroblast Growth Factor-21 as Biomarkers of Metabolic Dysfunction-Associated Steatohepatitis
November 2025
Metabolic dysfunction-associated steatotic liver disease (MASLD) is closely linked to comorbidities like obesity, type 2 diabetes, and cardiovascular disease. Given that liver biopsy is the diagnostic gold standard, there is a critical need for minimally invasive tests, particularly for the inflammatory form, metabolic dysfunction-associated steatohepatitis (MASH). In this discovery study, we investigated the plasma proteome to identify blood biomarkers for MASH and explored their potential...
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Improvement of Liver Fibrosis in Patients with MASLD Undergoing Pioglitazone Treatment: An Update
November 2025
Metabolic dysfunction-associated steatotic liver disease (MASLD) is defined as steatotic liver disease with at least one cardiometabolic risk factor, in the absence of harmful alcohol intake, and includes a spectrum of conditions. These range from isolated liver steatosis to metabolic dysfunction-associated steatohepatitis (MASH), fibrosis, cirrhosis, and MASH-related hepatocellular carcinoma. Patients with MASLD and type 2 diabetes are at increased risk of developing MASH and...
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Plasma Extracellular Vesicles Contain Protein Biomarkers for Capturing Stages of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Preliminary Exploratory Study
November 2025
Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing in both prevalence and severity, highlighting the need for non-invasive biomarkers to assess disease activity. Extracellular vesicles (EVs), which carry molecular cargo from their cells of origin, hold promise as accessible biomarkers. We performed proteomic profiling of plasma-derived EVs from 70 patients with MASLD to identify protein signatures associated with key histological features (steatosis, metabolic...
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Ginsenoside Rg2 ameliorates metabolic dysfunction-related steatohepatitis via the Nrf2 pathway by suppressing inflammation, apoptosis, oxidative stress and fibrosis
November 2025
CONCLUSION: This study is the first to confirm that G-Rg2 binds to and regulates Nrf2, and further illustrates that it alleviates MASH by activating the NRF2 signaling pathway to inhibit inflammation, cell apoptosis, oxidative stress, and fibrosis. This establishes a conceptual foundation for the future use of G-Rg2 in MASH treatment and supports the development of natural product-based therapeutic strategies derived from dietary sources.
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Aberrant lipid metabolism renders an aggressive behavior of T-lymphoblastic lymphoma in a MASH model
November 2025
Liver involvement of lymphomas is not rare in clinical patients. Metabolic dysfunction-associated steatohepatitis (MASH, formerly known as nonalcoholic steatohepatitis) is well accepted as a potential precursor for liver cancer, but it is unknown whether MASH could promote extranodal infiltration of lymphoma. In this study, the subpopulation of tumor-initiating cells and Wnt signaling pathway activation were studied in T-lymphoblastic lymphoma cells. Tumor growth, Wnt/β-catenin signaling, and...
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Intracellular IL-24 ameliorates lipid metabolic disorders in metabolic dysfunction-associated steatohepatitis by restoring the autophagy-lysosome pathway
November 2025
CONCLUSION: IL-24 preferentially utilizes the IL-22R1/IL-20R2 receptor complex to modulate the AMPK/mTOR/TFEB axis, thereby inducing autophagic-lysosomal activation, regulating glucose and lipid metabolism, and ameliorating hepatic lipid accumulation in MASH. These findings highlight IL-24 as a novel therapeutic target for MASH.
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The impact of semaglutide on liver outcomes in patients with or at risk of MASH: a dose and duration response meta-analysis of randomized trials
November 2025
CONCLUSION: Semaglutide represents a promising pharmacotherapeutic option for MASH, demonstrating significant improvements in histologic resolution, liver injury biomarkers, and metabolic parameters, particularly at higher doses and longer intervention durations, though its effect on fibrosis regression remains limited.
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Emerging Perspectives in the Diagnosis and Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Narrative Review
November 2025
Metabolic dysfunction-associated steatotic liver disease (MASLD, previously known as non-alcoholic fatty liver disease (NAFLD)) has emerged as the most prevalent chronic liver condition, affecting approximately 25% of the global population. The disease encompasses a spectrum ranging from simple steatosis to metabolic dysfunction-associated steatohepatitis (MASH, previously known as non-alcoholic fatty liver disease (NASH)), fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Despite its...
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Spatially resolved multi-omics of human metabolic dysfunction-associated steatotic liver disease
November 2025
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease worldwide. We generated single-cell and spatial transcriptomic and metabolomic maps from 61 human livers, including controls (n = 10), metabolic dysfunction-associated steatotic liver (MASL) (n = 17) and metabolic dysfunction-associated steatohepatitis (MASH) (n = 34). We identified microphthalmia-associated transcription factor (MITF) as a key regulator of the lipid-handling capacity of...
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Impact of Model for End-stage Liver Disease 3.0 on Waitlist Outcomes of Metabolic Dysfunction-associated Steatohepatitis Cirrhosis Among Liver Transplant Candidates
November 2025
CONCLUSIONS: Although MELD 3.0 reclassifies a substantial proportion of patients with MASH-particularly women-it does not appear to increase transplant access despite higher predicted mortality risk. These findings highlight residual gaps in how MELD 3.0 captures clinical risk in MASH cirrhosis and underscore the need for prospective data following its implementation.
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Semaglutide from Bench to Bedside: The Experimental Journey Towards a Transformative Therapy for Diabetes, Obesity and Metabolic Liver Disorders
November 2025
CONCLUSIONS: The trajectory of semaglutide exemplifies how intentional peptide design, iterative translational research, and outcome-driven clinical trial design can lead to groundbreaking therapies for complex metabolic disorders.
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Involvement of Activin E depletion in metabolic dysfunction-associated steatohepatitis
November 2025
Activin E is a liver-derived hepatokine belonging to the transforming growth factor-β superfamily, and it promotes energy expenditure by activating brown and beige adipocytes. Activin E also possesses anti-lipolytic activity. When Activin E knockout (KO) mice are fed a high-fat diet, energy storage in adipose tissue is impaired, leading to ectopic fat accumulation in the liver. In this study, we investigated the involvement of Activin E depletion in metabolic dysfunction-associated...
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Tank-Binding Kinase 1 protects against MASH progression via mitochondrial quality control
November 2025
Mitochondrial dysfunction is a critical driver of metabolic dysfunction-associated steatotic liver disease (MASLD) progression to steatohepatitis (MASH), yet the mechanisms governing mitochondrial quality control in hepatocytes remain poorly defined. Here, we identify TANK-binding kinase 1 (TBK1) as an essential regulator of hepatic mitophagy and lysosomal activity. Using TBK1-deficient hepatocytes and liver-specific TBK1 knockout (LTKO) mice, we show that TBK1 loss leads to the accumulation of...
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MicroRNA-21 is a potential therapeutic agent targeting Tgfbi and mitigating high-fat-diet-induced liver disease and cancer
November 2025
Liver disease, including hepatocellular carcinoma (HCC), is a major global health concern, claiming approximately 2 million lives worldwide annually, yet curative treatments remain elusive. In this study, we aimed to investigate the role of microRNA-21-5p (miR-21) in metabolic-dysfunction-associated steatotic liver disease (MASLD), metabolic-associated steatohepatitis (MASH), and HCC within the context of a Western choline-deficient (CD) high-fat diet (HFD) and offer potential therapeutic...
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