In this section : Liver Disease
Metabolic Syndrome Associated Fatty Liver Disease (MAFLD)
Decompensated Liver Disease
Acute Liver Failure
Asymptomatic Raised Transaminases (ALT & AST)
Ascites in Cirrhosis
Alcohol Related Liver Disease
Hepatitis C
Home | Articles | Liver Disease |
Metabolic Syndrome Associated Fatty Liver Disease (MAFLD)
Last updated 10th October 2022
Investigation & Management
- Should be sought for actively in everybody with any factor of metabolic syndrome. For example, among all type 2 diabetics 7 % of people have advanced fibrosis or cirrhosis often with normal transaminases.
- Absence of excess alcohol intake helps the diagnosis, but often people have more than risk factors. GGT ↑ it is a pointer towards alcohol
- Upper abdominal ultrasound scan findings consistent with fatty liver changes (increased hepatic echogenicity). Ultrasound has a pooled sensitivity of 85% and sensitivity of 94% for moderate to severe steatosis.
- Negative blood tests for other causes of hepatic disease such as viral hepatitis, autoantibody screen, immunoglobulin titres, ferritin and transferrin saturation.
- Do not use routine liver blood tests to rule out NAFLD — be aware that liver blood tests and liver ultrasound appearances may be normal in people with NAFLD and do not necessarily reflect the stage of disease.
- Use a first-line non-invasive tool to assess the level of fibrosis, such as Fibrosis- 4 (FIB-4) or NAFLD Fibrosis Score (NFS). Patients with a low score can be managed in primary care.
- If the person is at high risk of advanced liver fibrosis, refer to a hepatology specialist for further assessment and management (NICE October 2021).
Content by Dr Mathis Heydtmann & Dr Moawad Mahgoub