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Diagnosis, evaluation, and treatment of NAFLD
Figure 1 Clinical care pathways for patients with suspected or confirmed NAFLD
*Metabolic risk factors include central obesity, high triglycerides> 1.
#FIB-4, some studies have shown that FIB-4 is less specific in patients aged ≥ 65 years and recommends raising the lower threshold to 2.
1.
2.
3.
4.
5.
6.
Among existing drugs, vitamin E, pioglitazone, glucagon-like peptide-1 receptor agonists, and sodium-glucose synergistic transporter-2 inhibitors have been shown to reduce liver fat and inflammation
in patients with steatohepatitis.
These drugs may improve both liver condition and metabolic profile
.
8.
Bariatric surgery is currently the most effective treatment for severely obese patients to lose weight, and it can also improve liver histological lesions in patients with steatohepatitis and reduce the occurrence
of liver-related complications.
Patients with a body mass index >40 kg/m2 (or >35 kg/m2 with metabolic complications) may consider bariatric surgery, but the surgical risks must be carefully assessed and kept in touch
with the surgical team.
References: Wong VWS, Zelber-Sagi S, Cusi K, et al.
Management of NAFLD in primary care settings.
Liver Int.
2022 Aug 20.
doi: 10.
1111/liv.
15404.