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Semin Liver Dis 2023; 43(02): 133-141
DOI: 10.1055/a-2082-5203
Review Article

Screening for At-Risk Nonalcoholic Fatty Liver Disease in the Primary Care Setting

Esteban Urias
1   Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
,
Vincent L. Chen
2   Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
› Author Affiliations Funding V.L.C. was supported in part by NIDDK (K08 DK132312).
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Abstract

While nonalcoholic fatty liver disease is a leading cause of end-stage liver disease, most patients with nonalcoholic fatty liver disease do not develop cirrhosis and its complications. Therefore, risk stratification using inexpensive, noninvasive screening modalities is critical to avoid overdiagnosis and overtreatment of a large proportion of the population. In this review, we discuss the data supporting screening and current professional society recommendations on this topic. Screening for at-risk nonalcoholic fatty liver disease is recommended in patients with risk factors including diabetes, the metabolic syndrome, hepatic steatosis, and elevated aminotransferases. Screening typically consists of noninvasive testing using serum biomarkers followed by elastography using specialized imaging modalities. This sequential screening approach accurately identifies both high- and low-risk patients and is cost-effective when applied to at-risk populations. In conclusion, screening for advanced nonalcoholic fatty liver disease in the primary care setting is a crucial part of identifying high-risk patients who may benefit from aggressive intervention while avoiding overtreatment of patients at low risk of liver-related complications.

Keywords

noninvasive tests - NIT - advanced fibrosis - cirrhosis - NASH

Authors' Contribution

E.U. and V.L.C. contributed to the drafting and critical review of the manuscript.




Publication History

Accepted Manuscript online:
27 April 2023

Article published online:
16 May 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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