Identification of High Risk NAFLD Patients in Endocrinology Clinics

• Published in: Endocrine practice
• Main Authors: Younossi, Zobair M, Henry, Linda, Isaacs, Scott, Cusi, Kenneth
• Format: Journal Article
• Language: English
• Published: United States 03.07.2023
• Subjects: NAFLD; non-invasive tests; T2D; FIB-4; obesity
• ISSN: 1530-891X

As the twin epidemics of obesity and type 2 diabetes continue to increase world-wide, so does the associated chronic liver disease, nonalcoholic fatty liver disease (NAFLD). Although NAFLD has been thought of as a benign liver disease, the current evidence suggests that NAFLD is a complex liver disease that, for approximately 20% of patients, can progress to fibrosis, cirrhosis, hepatocellular carcinoma, liver transplant, and death. Importantly, given NAFLD's association with metabolic syndrome, the number one cause of death among those with NAFLD is related to cardiovascular diseases. In addition, NAFLD is associated with impaired patient reported outcomes and a significant economic burden. As such, efforts are now aimed at using non-invasive tests (NITs) to identify patients with NAFLD and those who are at risk for liver disease progression and adverse outcomes in endocrinology practices whereby appropriate risk stratification and referrals can be undertaken. In this review, we discuss the most common NITs used and provide a simple clinically relevant algorithm using these NITs to identify patients with NAFLD who at risk for adverse outcomes and the subsequent clinical management and referral.