Having a high suspicion for NAFLD in primary care settings in patients at high risk (type II diabetes, metabolic syndrome and etc ) & when concerning - abdominal US & FIB-4/APRI & then referral to hepatology w/fibroscan. But it’s hard... there’s no one lab test
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And definitely have your liver checked out using a Fibroscan exam. Book yours today at http://www.tawazunhealth.com/lifestyle
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These figures are an underestimate of 'real life'; papers in the SR are data from secondary/tertiary referral centres where many of hospital referrals triggered by elevated ALT. Nearer 70-90% normal ALT in primary care NAFLD screening studies
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Its essential GP are aware of complex nature of nafld patients. LFT's are one part of the picture. We have done a number of teaching days in Yorkshire for GP's around liver disease and we've seen benefit; through non invasive screens being completed and appropriate referrals.
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its not shocking, These enzymes r quite normal even in grade 4 fibrosis. best to use Liver Elastography ,Haemogram along other blood tests & Clinical symptoms to judge severity of NASH.
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