Published online Dec 27, 2021. doi: 10.4254/wjh.v13.i12.2104
Peer-review started: April 21, 2021
First decision: June 23, 2021
Revised: July 2, 2021
Accepted: November 15, 2021
Article in press: November 15, 2021
Published online: December 27, 2021
Processing time: 249 Days and 20 Hours
Elevated liver function tests (LFTs) often represent the main reason for referring patients with metabolic-associated fatty liver disease (MAFLD) to secondary and tertiary care.
In MAFLD, liver function tests may both under and over-estimate liver disease. Moreover, difference in upper normal limit (UNL) of LFTs is consistent across the literature.
As such, we investigated the potential use of different UNLs of LFTs in MAFLD.
We evaluated the use of a lower UNL of ALT vs histology and liver stiffness measurement in a cohort of 436 patients with non-alcoholic fatty liver disease in a tertiary care centre.
Modifying the upper normal limit of LFTs does not improve the diagnostic performance of the test in MAFLD.
In MAFLD, the risk-stratification should rely on a combination of risk factors and non-invasive markers, rather than on LFTs alone.
Future research should focus on identifying biomarkers for diagnosing metabolic-associated steato-hepatitis and advanced fibrosis.