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Review
. 2022 Jul;12(Suppl 1):S26-S36.
doi: 10.5005/jp-journals-10018-1364.

Work-up for Incidentally Detected NAFLD: How Far is It Worth?

Saurabh Mishra  1 , Harish Bhujade  2 , Amna Subhan Butt  3 , Lubna Kamani  4 , Madhumita Premkumar  1
Affiliations
Review

Work-up for Incidentally Detected NAFLD: How Far is It Worth?

Saurabh Mishra et al. Euroasian J Hepatogastroenterol. 2022 Jul.

Abstract

The incidence of nonalcoholic fatty liver disease (NAFLD) has seen a steep rise in parallel with the global obesity and metabolic syndrome epidemic. The presence of NAFLD contributes to significant socioeconomic burden due to healthcare costs, progression of liver disease as non-alcoholic steatohepatitis (NASH), and later cirrhosis and hepatocellular carcinoma (HCC). With the advent of widely available imaging, it is also being detected as an incidental diagnosis in individuals with systemic disease like metabolic syndrome, diabetes, chronic cardiac disease, polycystic ovarian syndrome, etc. or in asymptomatic persons on presurgical evaluation or even annual health assessments. Gastroenterologists, hepatologists, physicians and surgeons need to be updated about the new diagnostic criteria of Metabolic (dysfunction)-associated fatty liver disease, noninvasive tests (NITs) of liver fibrosis, new tools of elastography, and identification of those with high-risk disease. In this review, we appraise the relevance of new diagnostic definitions, steatosis and fibrosis estimation tests, advanced imaging like magnetic resonance elastography and proton density fat fraction and discuss the diagnostic algorithm for incidentally detected NAFLD.

How to cite this article: Mishra S, Bhujade H, Butt AS, et al. Work-up for Incidentally Detected NAFLD: How Far is It Worth? Euroasian J Hepato-Gastroenterol 2022;12(Suppl 1):S26-S36.

Keywords: Acoustic radiation force impulse; Incidental NAFLD; Liver fibrosis; Magnetic resonance imaging-proton density fat fraction; Metabolic (Dysfunction)-associated fatty liver disease; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis; Transient elastography.

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Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Fig. 1
Fig. 1
Clinical continuum in incidental NAFLD
Flowchart 1
Flowchart 1
Algorithm to evaluate incidentally detected fatty liver AST, aspartate aminotransferase; FAST, fibroscan plus AST score; HCC, hepatocellular carcinoma; LSM, liver stiffness measurement; MRE, magnetic resonance elastography; NAFLD, nonalcoholic fatty liver disease; NFS, NAFLD fibrosis score; VCTE, vibration controlled transient elastography
Fig. 2
Fig. 2
Types of elastography
Figs 3A and B
Figs 3A and B
Magnetic resonance elastography. Panel (I) MR Dixon sequences for fat detection, (A) In phase image; (B) Opposed phase image; (C) Fat-only image; (D) Water-only image, Panel (II) MR elastogram obtained using applicator placed over right hypochondriac region
Fig. 4
Fig. 4
Metabolic risk factors in NAFLD–MAFLD diagnostic conundrum
See this image and copyright information in PMC

References

    1. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328–357. doi: 10.1002/hep.29367. - DOI - PubMed
    1. Duseja A, Singh SP, Saraswat VA, et al. Non-alcoholic fatty liver disease and metabolic syndrome-position paper of the Indian National Association for the study of the liver, endocrine society of India, Indian college of cardiology and Indian Society of Gastroenterology. J Clin Exp Hepatol. 2015;5(1):51–68. doi: 10.1016/j.jceh.2015.02.006. - DOI - PMC - PubMed
    1. Zhai M, Liu Z, Long J, et al. The incidence trends of liver cirrhosis caused by nonalcoholic steatohepatitis via the GBD study 2017. Sci Rep. 2021;11(1):1–9. doi: 10.1038/s41598-021-84577-z. - DOI - PMC - PubMed
    1. Wong RJ, Singal AK. Trends in liver disease etiology among adults awaiting liver transplantation in the United States, 2014–2019. JAMA Netw Open. 2020;3(2):e1920294. doi: 10.1001/jamanetworkopen.2019.20294. - DOI - PubMed
    1. Li J, Zou B, Yeo YH, et al. Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2019;4(5):389–398. doi: 10.1016/S2468-1253(19)30039-1. - DOI - PubMed

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