Screening for nonalcoholic fatty liver disease-when, who and how?

Figure 1 Nonalcoholic fatty liver disease patient proportions according to risk assessment. Stepwise enrichment of nonalcoholic fatty liver disease (NAFLD) patients at risk for advanced fibrosis using a three-step strategy with score-based primary testing in a subgroup of the general population at risk for NAFLD and elastometric secondary testing to identify candidate patients for liver biopsy represents the third and final step in most algorithms. Patients with a diagnosis of NAFLD by either surrogate scores or ultrasound (20%-30% of the general population) are divided into low-risk vs intermediate-to-high-risk subgroups (the latter 7%-10% of the general population). After elastometry testing, half of these subjects can be assigned to a high likelihood of advanced fibrosis F3/F4 and should be subjected to liver biopsy. NAFLD: Nonalcoholic fatty liver disease.