New Guidelines Focus on NAFLD in Lean People
Ongoing follow-up and lifestyle interventions are needed in lean patients with nonalcoholic fatty liver disease (NAFLD), suggests a panel of experts in a recent review. They also urge screening for NAFLD in individuals who are older than 40 years with type 2 diabetes, even if they are not overweight. NAFLD is a leading cause of chronic liver disease that affects more than 25% of the US and worldwide populations, note lead author Michelle T. Long, MD, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, and colleagues. They add that around one quarter of those affected have nonalcoholic steatohepatitis, which is associated with significant morbidity and mortality due to complications of liver cirrhosis, hepatic decompensation, and hepatocellular carcinoma.
@mithu The 15 best practice advice statements covered a wide range of clinical areas, first defining lean as a body mass index (BMI) < 25 in non-Asian persons and < 23 in Asian persons. The authors go on to stipulate, for example, that lean individuals in the general population should not be screened for NAFLD, but that screening should be considered for individuals older than 40 years with type 2 diabetes. More broadly, they write that the condition should be considered in lean individuals with metabolic diseases, such as type 2 diabetes, dyslipidemia, and hypertension, as well as elevated values on liver biochemical tests or incidentally noted hepatic steatosis.