Screening for MASLD (NAFLD, NASH, MASH, liver disease)

Описание: MASLD, NAFLD, MASH, NASH, Fib-4, Transient Elastography, Fibroscan, Mediterranean Diet, Metabolic Syndrome, Syndrome X, Type 2 Diabetes, Hypertension, Dyslipidemia, OSA (obstructive sleep apnea), PCOS (polycystic ovarian syndrome)

NICE guidelines: https://pubmed.ncbi.nlm.nih.gov/27441...
Fib-4 cutoffs https://www.aasld.org/liver-fellow-ne...

Under 35: consider alternate test than fib-4, ex fibroscan
35-64: fib-4 less than 1.3 fibrosis unlikely, 1.3-2.67, need further testing, greater than 2.67 fibrosis likely
65 and older: fib-4 less than 2 fibrosis unlikely, 2-2.67, need further testing, greater than 2.67 fibrosis likely


Elastography cutoffs:
METAVIR STAGE SHEAR WAVE SPEED (M/SEC)
F0-F1: less than 1.66
F2-F3: 1.66-1.98
F4: greater than 1.99
Elastography assessment of liver fibrosis: Society of Radiologists in Ultrasound conference statement. Radiology 2015, June 16, Pages 1-17.
Comparison of transient elastography and fibroscan: https://www.ncbi.nlm.nih.gov/pmc/arti...

AASLD guidelines: https://doi.org/10.1002/hep.29367
European guidelines: https://doi.org/10.1016/j.jhep.2015.1...

Additional references:
Eslam, M., Newsome, P. N., Sarin, S. K., Anstee, Q. M., Targher, G., Romero-Gomez, M., Zelber-Sagi, S., Wai-Sun Wong, V., Dufour, J. F., Schattenberg, J. M., Kawaguchi, T., Arrese, M., Valenti, L., Shiha, G., Tiribelli, C., Yki-Järvinen, H., Fan, J. G., Grønbæk, H., Yilmaz, Y., Cortez-Pinto, H., … George, J. (2020). A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. Journal of hepatology, 73(1), 202–209. https://doi-org.samuelmerritt.idm.ocl...
Tilg, H., and Effenberger, M. (2020). From NAFLD to MAFLD: when pathophysiology succeeds. Nat Rev Gastroenterol Hepatol 17, 387–388. https://doi.org/10.1038/s41575-020-03...
Mitra, S., De, A., & Chowdhury, A. (2020). Epidemiology of non-alcoholic and alcoholic fatty liver diseases. Translational gastroenterology and hepatology, 5, 16. https://doi.org/10.21037/tgh.2019.09.08
Dewidar, B., Kahl, S., Pafili, K., & Roden, M. (2020). Metabolic liver disease in diabetes - From mechanisms to clinical trials. Metabolism: clinical and experimental, 154299. Advance online publication. https://doi.org/10.1016/j.metabol.202...
Kelly, N & Wattacheril, J. (2019). Nonalcoholic Fatty Liver Disease: Evidence-Based Management and Early Recognition of Nonalcoholic Steatohepatitis. Journal for Nurse Practitioners, 15(9), 622-626.