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Abstract: Non-alcoholic fatty liver disease (NAFLD) affects at least 25% of the general population and is an increasingly important cause of cirrhosis and hepatocellular carcinoma. Although it is the research focus of the hepatology field, it is clear that primary care physicians are seeing the majority of NAFLD patients and are in a pivotal position to provide quality care. In this article, we review the role of primary care in the management of NAFLD. NAFLD is common in patients with diabetes, obesity and other metabolic risk factors. Abdominal ultrasonography is the most commonly used method to diagnose fatty liver. Simple fibrosis scores have high negative predictive values in excluding advanced liver fibrosis and future liver-related events and can be used in primary care as initial evaluation. An abnormal result should be followed by subsequent workup or specialist referral. Primary care is the ideal setting to institute multidisciplinary care, especially the involvement of dietitians and physical activity trainers in lifestyle intervention, as well as initiating the discussion of bariatric surgery in patients with severe obesity. Although specific drug treatment for steatohepatitis would require a more precise diagnosis, metabolic drugs that improve both steatohepatitis and cardiovascular outcomes (e.g. glucagon-like peptide-1 receptor agonists) may be considered in patients with NAFLD.
Fuente: Liver Int . 2022 Nov;42(11):2377-2389
Publisher: Wiley-Blackwell
Year of publication: 2022
No. of pages: 13
Publication type: Article
DOI: 10.1111/liv.15404
ISSN: 1478-3223,1478-3231
Publication Url: https://www.doi.org/10.1111/liv.15404
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WONG, VINCENT W S
ZELBER-SAGI, SHIRA
CUSI, KENNETH
CARRIERI, PATRIZIA
WRIGHT, EUGENE
JAVIER CRESPO GARCIA
LAZARUS, JEFFREY V
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