Diagnostic tools for diagnosis of #NAFLD and complications by Dr. Lomonaco #AACE2022 #endotwitter
#NAFLD has effects on other conditions including DM, CVD, CKD etc due to increased hyperinsulinemia, insulin resistance, proinflammatory factors etc
How do we screen for #NAFLD and find the ones with fibrosis? A lot will be missed if just checking transaminases. FIB-4 and NFS is a better screening tool
Promising performance in using biomarkers to diagnose/screen for fibrosis. ELF with high sensitivity but low specificity to exclude fibrosis
Now on to imaging modalities -- Liver ultrasound Pros: High availability, low cost
• Cons: Not quantitative, low diagnostic accuracy for steatosis (20-30%)
VCTE -- Pros: easy to be trained and simple to use, large supporting literature, not time-consuming and
available at point-of-care
Cons: device is expensive (although testing affordable); less accurate in cases of mild fibrosis
MRE most accurate of imaging modalities to measure liver fibrosis but expensive and time consuming. LIver biopsy is still the gold standard but high cost
New AACE guideline algorithm for screening for advanced fibrosis related NAFLD
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