Management of NAFLD in primary care settings
| Autor: | Vincent W.S. Wong, Shira Zelber‐Sagi, Kenneth Cusi, Patrizia Carrieri, Eugene Wright, Javier Crespo, Jeffrey V. Lazarus |
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| Přispěvatelé: | The Chinese University of Hong Kong [Hong Kong], University of Haifa [Haifa], University of Florida [Gainesville] (UF), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), Duke University [Durham], Hospital Universitario Marqués de Valdecilla [Santander], Marqués de Valdecilla Research Institute - Instituto de Investigación Marqués de Valdecilla [Santander] (IDIVAL), Instituto de Salud Global - Institute For Global Health [Barcelona] (ISGlobal), University of Barcelona |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Liver Cirrhosis
general practice MESH: Humans Primary Health Care Hepatology MESH: Non-alcoholic Fatty Liver Disease cirrhosis [SDV]Life Sciences [q-bio] non-alcoholic fatty liver disease MESH: Glucagon-Like Peptide-1 Receptor Glucagon-Like Peptide-1 Receptor MESH: Primary Health Care non-alcoholic steatohepatitis Humans MESH: Liver Cirrhosis liver fibrosis |
| Zdroj: | Liver International Liver International, 2022, 42 (11), pp.2377-2389. ⟨10.1111/liv.15404⟩ |
| ISSN: | 1478-3223 1478-3231 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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