Non-Alcoholic Fatty Liver Disease, the HEpatic Response to Oral Glucose, and the Effect of Semaglutide (NAFLD HEROES)

This NIH study (called NAFLD HEROES) investigates non-alcoholic fatty liver disease — a condition where fat builds up in the liver in people who drink little to no alcohol. It tests the drug semaglutide (a medication also used for diabetes and weight loss) to see if it can reduce liver fat and improve liver health. Participants undergo detailed liver assessments including biopsies and specialized MRI scans to measure fat content before and after treatment. The study has two main patient groups: people with confirmed fatty liver disease, and healthy volunteers without liver disease for comparison. The eligibility criteria are detailed because liver biopsies are involved, and many medications and conditions can affect liver health in ways that would confuse the study results. This is a rigorous, carefully controlled NIH clinical trial conducted in the United States. You may be eligible if: - You are 18 years or older - You have confirmed fatty liver disease (by imaging or liver biopsy in the past 12 months) - Your alcohol intake is below 30g/day (men) or 20g/day (women) - Your diabetes (if present) is controlled with HbA1c ≤9% and only on metformin or lifestyle therapy - You are willing to undergo liver biopsies You may NOT be eligible if: - You are pregnant or breastfeeding - You have HIV, active hepatitis B, or hepatitis C infection - You have significant heart, kidney, or advanced liver disease - You use insulin, GLP-1 agonists, or certain diabetes medications - You have had gastric bypass or bariatric surgery - You have a personal or family history of medullary thyroid carcinoma or MEN-2 syndrome Talk to your doctor to see if this trial is right for you.