Abstract
BACKGROUND There is an urgent need to risk stratify patients with suspected nonalcoholic fatty liver disease (NAFLD) and identify those with fibrotic nonalcoholic steatohepatitis. This study aims to apply a simple diagnostic algorithm to identify subjects with at-risk NAFLD in the general population. AIM To apply a simple diagnostic algorithm to identify subjects with at-risk NAFLD in the general population. METHODS Adult subjects were included from the National Health and Nutrition Examination Survey database (2017-2018) if they had elevated alanine aminotransferase (ALT) and excluded if they had evidence of viral hepatitis or significant alcohol consumption. A fibrosis-4 (FIB4) cutoff of 1.3 differentiated patients with low risk vs high risk disease. If patients had FIB4 > 1.3, a FAST score < 0.35 ruled out advanced fibrosis. Patients with FAST > 0.35 were referred to a specialist. The same algorithm was applied to subjects with type 2 diabetes mellitus (T2DM).RESULTS Three thousand six hundred and sixty-nine patients were identified who met all inclusion and exclusion criteria. From this cohort, 911 (28.6%) patients had elevated ALT of which 236 (22.9%) patients had elevated FIB4 scores ≥ 1.3. Among patients with elevated FIB4 score, 75 (24.4%) had elevated FAST scores, ruling in advanced fibrosis. This accounts for 2.0% of the overall study population. Applying this algorithm to 737 patients with T2DM, 213 (35.4%) patients had elevated ALT, 85 (37.9%) had elevated FIB4, and 42 (46.1%) had elevated FAST scores. This accounts for 5.7% of the population with T2DM.
Original language | English (US) |
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Pages (from-to) | 1598-1607 |
Number of pages | 10 |
Journal | World Journal of Hepatology |
Volume | 14 |
Issue number | 8 |
DOIs | |
State | Published - Jan 2022 |
Keywords
- Diabetes
- Endocrinology
- Hepatology
- Non-alcoholic fatty liver disease
- Nonalcoholic steatohepatitis
- Primary care
ASJC Scopus subject areas
- Hepatology