Non-alcoholic fatty liver disease screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

Overview

There is insufficient evidence to recommend routine screening for NAFLD in general population. However, screening is recommended in high-risk population groups(obesity, insulin resistance and patients with metabolic syndrome) as more than 50 million Americans have been estimated to have metabolic syndrome and about 80% of them have NAFD.

Screening

  • There is insufficient evidence to recommend routine screening for NAFLD in general population.[1][2][3]
  • However, American Gastroenterological Association Technical Review recommends screening for non-alcoholic fatty liver disease in population at high risk such as obesity, insulin resistance, and metabolic syndrome.
  • Screening is however complicated by the lack of accurate, noninvasive diagnostic tools for NAFLD and the lack of clear treatment that can be proposed to the patient.

However, the AGA recommend screening[4].

Workflows to promote screening may increase treatment[5].

Screening modalities

  • Serum tests of liver function

References

  1. Koot BGP, Nobili V (2017). "Screening for non-alcoholic fatty liver disease in children: do guidelines provide enough guidance?". Obes Rev. 18 (9): 1050–1060. doi:10.1111/obr.12556. PMID 28544608.
  2. Kummer S, Klee D, Kircheis G, Friedt M, Schaper J, Häussinger D; et al. (2017). "Screening for non-alcoholic fatty liver disease in children and adolescents with type 1 diabetes mellitus: a cross-sectional analysis". Eur J Pediatr. 176 (4): 529–536. doi:10.1007/s00431-017-2876-1. PMID 28213828.
  3. Glen J, Floros L, Day C, Pryke R, Guideline Development Group (2016). "Non-alcoholic fatty liver disease (NAFLD): summary of NICE guidance". BMJ. 354: i4428. doi:10.1136/bmj.i4428. PMID 27605111.
  4. Wattacheril JJ, Abdelmalek MF, Lim JK, Sanyal AJ (2023). "AGA Clinical Practice Update on the Role of Noninvasive Biomarkers in the Evaluation and Management of Nonalcoholic Fatty Liver Disease: Expert Review". Gastroenterology. doi:10.1053/j.gastro.2023.06.013. PMID 37542503 Check |pmid= value (help).
  5. Zhang X, Yip TC, Wong GL, Leow WX, Liang LY, Lim LL; et al. (2023). "Clinical care pathway to detect advanced liver disease in patients with type 2 diabetes through automated fibrosis score calculation and electronic reminder messages: a randomised controlled trial". Gut. doi:10.1136/gutjnl-2023-330269. PMID 37549979 Check |pmid= value (help).

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