ALT, AST, GGT and ALP: what they do and do not indicate about hepatic fat, why enzymes are a poor surrogate for histology, and where non-invasive fibrosis scores fit.
Stated plainly: lipase · a GLP-1 receptor agonist. The empirical answer seems settled. The explanation does not. If the honest answer is that nobody knows, I would…
Details up front: TSH · dulaglutide. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know how confident…
The case in front of me: HbA1c · liraglutide. This is one of those things that everyone repeats and nobody derives. This matters practically, not just academically,…
The particulars: potassium · semaglutide. I understand the observation; what I do not understand is the mechanism behind it. I have read the two review articles that…
Numbers first: ApoB · retatrutide. I suspect the usual explanation for this is wrong, or at least incomplete. I am aware this may have a boring answer. I would still…
Conditions: GGT · oral semaglutide. I want to know whether this is a real physical effect or an artefact of how it is measured. What prompted the question is an…
What I am working with: LDL-C · cagrilintide. I keep seeing this stated as a fact with no explanation attached, and unexplained facts make me suspicious. My…
Details up front: albumin-to-creatinine ratio · dulaglutide. I suspect the usual explanation for this is wrong, or at least incomplete. I am aware this may have a…
Setup, so nobody has to ask: lipase · cagrilintide. The empirical answer seems settled. The explanation does not. If the honest answer is that nobody knows, I would…
Conditions: ferritin · liraglutide. I want to know whether this is a real physical effect or an artefact of how it is measured. What prompted the question is an…
What I have: eGFR · orforglipron. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know how confident…
What I have: eGFR · dulaglutide. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know how confident the…
Stated plainly: ALT · cagrilintide. I keep seeing this stated as a fact with no explanation attached, and unexplained facts make me suspicious. My background is…
What I am working with: ALT · mazdutide. I keep seeing this stated as a fact with no explanation attached, and unexplained facts make me suspicious. My background is…
Baseline ALT was 24 U/L. Fourteen weeks into semaglutide it came back at 41 U/L, still inside the lab's quoted range of 0 to 50 but a 71% rise from where I started. I…
Details up front: TSH · retatrutide. I can predict the outcome but I cannot explain it, which means I will get the next case wrong. I would like to know how confident…
The clinician who ordered the panel was not concerned; I would still like to understand it. I would like help reading this properly rather than being told what…
For reference: cystatin C · survodutide. I understand the observation; what I do not understand is the mechanism behind it. I have read the two review articles that…
Every MASH trial reports large falls in ALT and AST alongside the histological endpoints, and the enzyme falls are usually much more impressive-looking than the…
The specifics, since they change the answer: cystatin C · ecnoglutide. I understand the observation; what I do not understand is the mechanism behind it. I have read…
Setup, so nobody has to ask: LDL-C · a GLP-1 receptor agonist. I keep seeing this stated as a fact with no explanation attached, and unexplained facts make me…
The specifics, since they change the answer: cystatin C · semaglutide. I understand the observation; what I do not understand is the mechanism behind it. I have read…
For reference: triglycerides · survodutide. I would like the mechanism, because I want to be able to reason about the cases nobody has written about. I have tried to…
Following on from the discussion of sampling variability: if simultaneous biopsies from the same liver disagree by a fibrosis stage in a meaningful fraction of cases,…
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