Description

Younossi et al reported criteria for identifying a patient with nonalcoholic fatty liver disease (NAFLD) who is at high risk. This can help to identify a patient who may benefit from more aggressive management. The authors are from Inova Health System and the Center for Outcomes Research in Liver Disease.


Patient selection: nonalcoholic fatty liver disease (NAFLD)

 

Parameters:

(1) AST to platelet ratio (APRI)

(2) FIB-4

(3) NAFLD Fibrosis Score (NFS)

 

Parameters

Finding

Points

APRI

<= 1.0

0

 

> 1.0

1

FIB-4

<= 1.45

0

 

> 1.45

1

NFS

<= -1.45

0

 

> -1.45

1

 

score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 3

• A score >= 2 indicates a high-risk patient.

• A high-risk patient should have liver stiffness measured. Liver stiffness >= 12 kPa is associated with cirrhosis. A liver stiffness from 8.01 to 11.99 was seen in 10% of study patients and was elevated liver function tests.


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