Primary care is where early detection and treatment of liver disease should begin and as Dr Alkhouri highlights here, all the right tools are already at hand.
The first step toward increasing early diagnosis of metabolic dysfunction-associated liver disease, or MASLD, in primary care is to develop and maintain a high level of suspicion for the disease in the patients in your practice at the greatest risk: those with type 2 diabetes, obesity, and metabolic syndrome, Naim Alkhouri, MD, chief medical officer, chief of transplant hepatology, and director of the fatty liver program at Arizona Liver Health, in Phoenix, said in a recent interview with Patient Care. The recommendation was part of his answer to a question about testing for MASLD in front-line practice and assessing which patients should be referred for additional evaluation by a hepatologist. In this short video, Alkhouri highlights the guideline-recommended sequence of tests that are also standard in primary care, how to use findings from the FIB-4 calculator to stratify patient risk. (Follow Dr Alkhouri on X @AlkhouriNaim)
For additional details on the study mentioned during this interview, see: Nagpal SJ, Kabbany MN, Mohamad B, Lopez R, Zein NN, Alkhouri N. Portal hypertension complications are frequently the first presentation of NAFLD in patients undergoing liver transplantation evaluation. Dig Dis Sci. 2016 Jul;61(7):2102-7. doi:10.1007/s10620-016-4124-3