Identifying patients with nonalcoholic fatty liver disease in primary care: how and for what benefit?

Schreiner, A. D. and Sattar, N. (2023) Identifying patients with nonalcoholic fatty liver disease in primary care: how and for what benefit? Journal of Clinical Medicine, 12(12), 4001. (doi: 10.3390/jcm12124001) (PMID:37373694) (PMCID:PMC10298910)

Abstract

Despite its increasing prevalence, nonalcoholic fatty liver disease (NAFLD) remains under-diagnosed in primary care. Timely diagnosis is critical, as NAFLD can progress to nonalcoholic steatohepatitis, fibrosis, cirrhosis, hepatocellular carcinoma, and death; furthermore, NAFLD is also a risk factor linked to cardiometabolic outcomes. Identifying patients with NAFLD, and particularly those at risk of advanced fibrosis, is important so that healthcare practitioners can optimize care delivery in an effort to prevent disease progression. This review debates the practical issues that primary care physicians encounter when managing NAFLD, using a patient case study to illustrate the challenges and decisions that physicians face. It explores the pros and cons of different diagnostic strategies and tools that physicians can adopt in primary care settings, depending on how NAFLD presents and progresses. We discuss the importance of prescribing lifestyle changes to achieve weight loss and mitigate disease progression. A diagnostic and management flow chart is provided, showing the key points of assessment for primary care physicians. The advantages and disadvantages of advanced fibrosis risk assessments in primary care settings and the factors that influence patient referral to a hepatologist are also reviewed.

• Item Type: Articles
• Additional Information: Medical writing support was funded by Pfizer Inc.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Sattar, Professor Naveed

Creator Roles

Sattar, N.: Conceptualization, Investigation, Writing – original draft, Writing – review and editing, Visualization

• Authors: Schreiner, A. D., and Sattar, N.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Journal of Clinical Medicine
• Publisher: MDPI
• ISSN: 2077-0383
• ISSN (Online): 2077-0383
• Published Online: 12 June 2023
• Copyright Holders: Copyright © 2023 The Authors
• First Published: First published in Journal of Clinical Medicine 12(12): 4001
• Publisher Policy: Reproduced under a Creative Commons License