FLI and FIB-4 in diagnosing metabolic dysfunction-associated steatotic liver disease in primary care: High prevalence and risk of significant disease
Introduction and Objectives: Public health policies in metabolic dysfunction-associated steatotic liver disease (MASLD) are still lacking. This study aims to estimate the prevalence and severity of MASLD in primary health care (PHC) through non-invasive markers. Patients and Methods: Two-phase study...
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Elsevier
2025-01-01
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| Series: | Annals of Hepatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268124003673 |
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| author | Mário Reis Álvares-da-Silva Márcia da Silva Vargas Soheyla Mohd Souza Rabie Gabriella Jonko Patricia Gabriela Riedel Larisse Longo Marcelo Rodrigues Gonçalves Vivian Cristine Luft Dvora Joveleviths |
| author_facet | Mário Reis Álvares-da-Silva Márcia da Silva Vargas Soheyla Mohd Souza Rabie Gabriella Jonko Patricia Gabriela Riedel Larisse Longo Marcelo Rodrigues Gonçalves Vivian Cristine Luft Dvora Joveleviths |
| author_sort | Mário Reis Álvares-da-Silva |
| collection | DOAJ |
| description | Introduction and Objectives: Public health policies in metabolic dysfunction-associated steatotic liver disease (MASLD) are still lacking. This study aims to estimate the prevalence and severity of MASLD in primary health care (PHC) through non-invasive markers. Patients and Methods: Two-phase study, including a retrospective (RETR) and a prospective (PROS) one, was carried out in PHC in Brazil. In RETR, metabolic and hepatic profiles of 12,054 patients, including FIB-4, were evaluated. In PROS, 350 patients were randomly selected and submitted to a clinical and nutritional assessment. Results: RETR (65.4 % women, mean age 55.3 years old): dyslipidemia, hypertension, and type 2 diabetes mellitus (T2DM) present in 40.8 %, 34.3 %, and 12.2 % of the electronic health records, respectively. Fasting glucose >100 mg/dL in 34.5 %, and glycated hemoglobin higher than 5.7 % in 51.5 %, total cholesterol >200 mg/dL and triglycerides >150 mg/dL in 40.8 % and 32.1 %, respectively. Median FIB-4 was of 1.33, 5 % >2.67. No one had MASLD as a diagnostic hypothesis; PROS (71.8 % women, mean age 58 years old): body mass index (BMI) ≥30 kg/m² in 31.8 %. MASLD prevalence (FLI≥ 30 + cardiometabolic features) of 62.1 %; 39.4 % of patients had FLI ≥60, with higher BMI, waist circumference, fasting glucose, triglycerides, AST, ALT and GGT, as well as lower HDL-cholesterol (p < 0.001). FIB-4>1.3 in 40 % and NAFLD Fibrosis Score (NFS)>-1.45 in 59.2 % of steatotic patients. Conclusions: There is a high prevalence of MASLD in PHC, with a significant risk of liver fibrosis. These findings reinforce we need to develop public policies to defeat MASLD epidemics. |
| format | Article |
| id | doaj-art-8a4777da73204b4cb9e4b14997f08836 |
| institution | Kabale University |
| issn | 1665-2681 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Annals of Hepatology |
| spelling | doaj-art-8a4777da73204b4cb9e4b14997f088362025-01-16T04:28:25ZengElsevierAnnals of Hepatology1665-26812025-01-01301101584FLI and FIB-4 in diagnosing metabolic dysfunction-associated steatotic liver disease in primary care: High prevalence and risk of significant diseaseMário Reis Álvares-da-Silva0Márcia da Silva Vargas1Soheyla Mohd Souza Rabie2Gabriella Jonko3Patricia Gabriela Riedel4Larisse Longo5Marcelo Rodrigues Gonçalves6Vivian Cristine Luft7Dvora Joveleviths8Graduate Program in Gastroenterology and Hepatology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, 90035-007, Rio Grande do Sul, Brazil; Experimental Laboratory in Hepatology and Gastroenterology, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, 90035-007, Rio Grande do Sul, Brazil; Gastroenterology and Hepatology Unit, HCPA, Porto Alegre, 90035-007, Rio Grande do Sul, Brazil; Department of Internal Medicine, UFRGS, Porto Alegre, 91501-970, Rio Grande do Sul, Brazil; Conselho Nacional de Desenvolvimento Científico e Tecnológico, CNPq Researcher, Brasília 71.605-001, Distrito Federal, Brazil; Corresponding author.Graduate Program in Gastroenterology and Hepatology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, 90035-007, Rio Grande do Sul, Brazil; Nutrition Unit, HCPA, Porto Alegre, 90035-007, Rio Grande do Sul, BrazilGraduate Program in Gastroenterology and Hepatology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, 90035-007, Rio Grande do Sul, Brazil; Nutrition Unit, HCPA, Porto Alegre, 90035-007, Rio Grande do Sul, BrazilGraduate Program in Gastroenterology and Hepatology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, 90035-007, Rio Grande do Sul, BrazilGraduate Program in Gastroenterology and Hepatology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, 90035-007, Rio Grande do Sul, BrazilGraduate Program in Gastroenterology and Hepatology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, 90035-007, Rio Grande do Sul, Brazil; Experimental Laboratory in Hepatology and Gastroenterology, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, 90035-007, Rio Grande do Sul, BrazilDepartment of Social Medicine, UFRGS, Porto Alegre, 90035-003, Rio Grande do Sul, Brazil; Department of Nutrition, School of Medicine, UFRGS, Porto Alegre, 90050-170, Rio Grande do Sul, Brazil; Graduate Program in Food, Nutrition and Health, School of Medicine, UFRGS, Porto Alegre, 90035-007, Rio Grande do Sul, BrazilDepartment of Social Medicine, UFRGS, Porto Alegre, 90035-003, Rio Grande do Sul, Brazil; Department of Nutrition, School of Medicine, UFRGS, Porto Alegre, 90050-170, Rio Grande do Sul, Brazil; Graduate Program in Epidemiology, School of Medicine, UFRGS, Porto Alegre, 90035-003, Rio Grande do Sul, BrazilGraduate Program in Gastroenterology and Hepatology, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, 90035-007, Rio Grande do Sul, Brazil; Experimental Laboratory in Hepatology and Gastroenterology, Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, 90035-007, Rio Grande do Sul, Brazil; Department of Social Medicine, UFRGS, Porto Alegre, 90035-003, Rio Grande do Sul, BrazilIntroduction and Objectives: Public health policies in metabolic dysfunction-associated steatotic liver disease (MASLD) are still lacking. This study aims to estimate the prevalence and severity of MASLD in primary health care (PHC) through non-invasive markers. Patients and Methods: Two-phase study, including a retrospective (RETR) and a prospective (PROS) one, was carried out in PHC in Brazil. In RETR, metabolic and hepatic profiles of 12,054 patients, including FIB-4, were evaluated. In PROS, 350 patients were randomly selected and submitted to a clinical and nutritional assessment. Results: RETR (65.4 % women, mean age 55.3 years old): dyslipidemia, hypertension, and type 2 diabetes mellitus (T2DM) present in 40.8 %, 34.3 %, and 12.2 % of the electronic health records, respectively. Fasting glucose >100 mg/dL in 34.5 %, and glycated hemoglobin higher than 5.7 % in 51.5 %, total cholesterol >200 mg/dL and triglycerides >150 mg/dL in 40.8 % and 32.1 %, respectively. Median FIB-4 was of 1.33, 5 % >2.67. No one had MASLD as a diagnostic hypothesis; PROS (71.8 % women, mean age 58 years old): body mass index (BMI) ≥30 kg/m² in 31.8 %. MASLD prevalence (FLI≥ 30 + cardiometabolic features) of 62.1 %; 39.4 % of patients had FLI ≥60, with higher BMI, waist circumference, fasting glucose, triglycerides, AST, ALT and GGT, as well as lower HDL-cholesterol (p < 0.001). FIB-4>1.3 in 40 % and NAFLD Fibrosis Score (NFS)>-1.45 in 59.2 % of steatotic patients. Conclusions: There is a high prevalence of MASLD in PHC, with a significant risk of liver fibrosis. These findings reinforce we need to develop public policies to defeat MASLD epidemics.http://www.sciencedirect.com/science/article/pii/S1665268124003673Liver fibrosisMetabolic dysfunction-associated steatotic liver diseaseMetabolic riskNonalcoholic fatty liver diseasePrimary care |
| spellingShingle | Mário Reis Álvares-da-Silva Márcia da Silva Vargas Soheyla Mohd Souza Rabie Gabriella Jonko Patricia Gabriela Riedel Larisse Longo Marcelo Rodrigues Gonçalves Vivian Cristine Luft Dvora Joveleviths FLI and FIB-4 in diagnosing metabolic dysfunction-associated steatotic liver disease in primary care: High prevalence and risk of significant disease Annals of Hepatology Liver fibrosis Metabolic dysfunction-associated steatotic liver disease Metabolic risk Nonalcoholic fatty liver disease Primary care |
| title | FLI and FIB-4 in diagnosing metabolic dysfunction-associated steatotic liver disease in primary care: High prevalence and risk of significant disease |
| title_full | FLI and FIB-4 in diagnosing metabolic dysfunction-associated steatotic liver disease in primary care: High prevalence and risk of significant disease |
| title_fullStr | FLI and FIB-4 in diagnosing metabolic dysfunction-associated steatotic liver disease in primary care: High prevalence and risk of significant disease |
| title_full_unstemmed | FLI and FIB-4 in diagnosing metabolic dysfunction-associated steatotic liver disease in primary care: High prevalence and risk of significant disease |
| title_short | FLI and FIB-4 in diagnosing metabolic dysfunction-associated steatotic liver disease in primary care: High prevalence and risk of significant disease |
| title_sort | fli and fib 4 in diagnosing metabolic dysfunction associated steatotic liver disease in primary care high prevalence and risk of significant disease |
| topic | Liver fibrosis Metabolic dysfunction-associated steatotic liver disease Metabolic risk Nonalcoholic fatty liver disease Primary care |
| url | http://www.sciencedirect.com/science/article/pii/S1665268124003673 |
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