From the Department of Medicine, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia.
J Am Board Fam Med. 2024 Jul-Aug;37(4):753-772. doi: 10.3122/jabfm.2023.230005R2.
The rising obesity epidemic is a phenomenon that has gained increasing attention from health providers and health policy makers. This led to recognition of nonalcoholic fatty liver disease (MASLD). The standard for its assessment has been histologic, which is neither practical nor acceptable by patients. Subsequently, a number of noninvasive assessment methods have been developed. However, despite ease of implementation, their confounding variables do hinder their accuracy. Nonetheless, the development of the liver stiffness measurement (LSM) and incorporation of other biological parameters has minimized but not eliminated the need for liver biopsy. Imaging methods are useful in evaluation, estimation, and following the progression of steatosis and fibrosis with particular attention to controlled attenuation parameter (CAP) and MRI-Proton Density Fat Fraction (MRI-PDFF). The choices for the family physician are broad and rely on tests' availability, cost, and patient acceptance. Great efforts have been undertaken to produce more robust and novel noninvasive markers that indicate fibrinogenesis directly in an implementable and cost-effective way.
肥胖症的流行是一个越来越受到医疗服务提供者和卫生政策制定者关注的现象。这导致了非酒精性脂肪性肝病（NAFLD）的认识。其评估的标准是组织学，这既不实际也不被患者接受。随后，开发了许多非侵入性评估方法。然而，尽管易于实施，但它们的混杂变量确实会影响其准确性。尽管如此，肝硬度测量（LSM）的发展和其他生物参数的纳入已经最小化但并未消除对肝活检的需求。成像方法在评估、估计和监测脂肪变性和纤维化的进展方面很有用，特别关注受控衰减参数（CAP）和 MRI-质子密度脂肪分数（MRI-PDFF）。家庭医生的选择范围很广，取决于测试的可用性、成本和患者的接受程度。已经做出了巨大的努力来产生更强大和新颖的非侵入性标记物，以可实现和具有成本效益的方式直接指示纤维蛋白生成。
