Biochemical assessment of metabolic associated fatty liver disease

Abstract

Metabolic-associated fatty liver disease (MAFLD) is defined as fat accumulation in the liver in the presence of metabolic alterations. This disorder is generally asymptomatic and may progress to severe liver disease, which are linked to inflammation and/or fibrosis. MAFLD has a high prevalence (26%) and therefore a considerable number of patients are at high risk of having advanced liver disease. This document provides an overview of the most relevant serological markers in the characterization and diagnosis of MAFLD. An example is provided of a routine diagnostic algorithm that incorporates serological testing. A range of useful serological scores are currently available for the management of MAFLD patients, especially for the stratification of patients at risk of fibrosis. A large proportion of the population is at risk of developing severe liver disease. The integration of non-invasive serological markers in the stratification of patients at risk for liver fibrosis may contribute to improve the control and management of MAFLD patients.

Management of non-alcoholic fatty liver disease incidentally detected during other medical assessments

“…Commonly, patients with NAFLD may present with elevated concentrations of aminotransferases, particularly ALT and AST levels. 8 ALP can also be increased in parallel to other liver function markers. Furthermore, low levels of total protein in the blood can also occur because of impaired liver function; however, bilirubin and albumin levels are rarely altered.…”

“…Furthermore, low levels of total protein in the blood can also occur because of impaired liver function; however, bilirubin and albumin levels are rarely altered. 8 …”

“…Furthermore, low levels of total protein in the blood can also occur because of impaired liver function; however, bilirubin and albumin levels are rarely altered. 8 The management of HILI and DILI first involves interrupting all suspected traditional medicines, and liver function should be carefully monitored. 9 As a second line, supportive therapy with hepatoprotective drugs (N-acetylcysteine, antioxidants and corticosteroids) may be suggested to patients with DILI or other forms of liver injury.…”

Chronic liver disease and management with silymarin: an introductory review of a clinical case collection

“…MAFLD is a new designation of NAFLD acknowledging metabolic syndrome as a key factor contributing to prolonged liver injury and encompassing a broad range of liver lesions associated with fat accumulation, specifically steatosis. 1 , 14 , 15 In the past, a diagnosis of NAFLD relied on the exclusion of significant alcohol consumption or drug-induced liver disease. However, the updated diagnostic criteria for MAFLD discard these exclusionary conditions and introduce ‘positive’ criteria.…”

Nonalcoholic Fatty Liver Disease-Related Hepatocellular Carcinoma: The Next Threat after Viral Hepatitis

“…Among them, Fib-4 is easy and widely used. In a recent study comparing different non-invasive scores, HFS was the best performer for the identification of significant (F0–1 vs. F2–4, AUC = 0.758) and advanced (F0–2 vs. F3–4, AUC = 0.805) fibrosis, while NFS and FIB-4 showed the best performance for detecting histological cirrhosis (range AUCs 0.85–0.88) [ 50 ]. Imaging techniques such as Fibroscan and magnetic resonance elastography.…”