Clin Mol Hepatol > Epub ahead of print
Screening strategy for non-alcoholic fatty liver disease
Saisai Zhang1, Lung-Yi Mak1,2, Man-Fung Yuen1,2, Wai-Kay Seto1,2,3
1Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong
2State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong
3Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
Correspondence :  Wai-Kay Seto ,
Tel: +86 75586913333, Fax: +86 75586913108, Email: wkseto@hku.hk
Received: October 25, 2022  Revised: November 13, 2022   Accepted: November 16, 2022
ABSTRACT
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, affecting approximately 25% of the general population worldwide, and is forecasted to increase global health burden in the 21st century. With the advancement of non-invasive tests for assessing and monitoring of steatosis and fibrosis, NAFLD screening is now feasible, and is increasingly highlighted in international guidelines related to hepatology, endocrinology, and pediatrics. Identifying high-risk populations (e.g., diabetes mellitus, obesity, metabolic syndrome) based on risk factors and metabolic characteristics for non-invasive screening is crucial and may aid in designing screening strategies to be more precise and effective. Many screening modalities are currently available, from serum-based methods to ultrasonography, transient elastography, and magnetic resonance imaging, although the diagnostic performance, cost, and accessibility of different methods may impact the actual implementation. A two-step assessment with serum-based fibrosis-4 index followed by imaging test vibration-controlled transient elastography can be an option to stratify the risk of liverrelated complications in NAFLD. There is a need for fibrosis surveillance, as well as investigating the cost-effectiveness of different screening algorithms and engaging primary care for first-stage triage screening.
KeyWords: NAFLD; Metabolic diseases; Diabetes mellitus; Fatty liver; Fibrosis

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