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Endocrinology

Diagnosis and Management of Nonalcoholic Fatty Liver Disease

To identify the key insights or developments described in this article

1 Credit CME

JAMA

Published Online: October 16, 2023

JAMA Clinical Guidelines Synopsis

Article Information and Disclosures

Peggy B. Leung, MD¹;

Andrew M. Davis, MD, MPH²;

Sonal Kumar, MD, MPH³

Author Affiliations

¹Division of General Internal Medicine, Weill Cornell Medicine, New York, New York
²Section of General Internal Medicine, University of Chicago, Chicago, Illinois
³Division of Gastroenterology and Hepatology, Department of Medicine, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York

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NAFLD is characterized by hepatic steatosis associated with metabolic abnormalities such as insulin resistance, dyslipidemia, obesity, and hypertension. Prevalence of NAFLD in US adults approaches 40%, with high-risk fibrosis more than doubling between 2000 and 2016 (National Health and Nutrition Examination Survey).¹ Less than 5% of patients with NAFLD are aware of their condition, and 12% to 14% also have NASH, which can progress to advanced fibrosis, cirrhosis, and hepatocellular carcinoma. Diagnostic screening and initial treatment for NAFLD can often be carried out in primary care settings.²

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Article Information

Corresponding Author: Peggy B. Leung, MD, Weill Cornell Medicine, 505 E 70th St, HT-4, New York, NY 10021 (pbl9001@med.cornell.edu).

Published Online: October 16, 2023. doi:10.1001/jama.2023.17935

Conflict of Interest Disclosures: Dr Kumar reported receiving personal fees from Intercept, Gilead, Ipsen, and Novo Nordisk. No other disclosures were reported.

References

Golabi P , Paik JM , Harring M , et al. Prevalence of high and moderate risk nonalcoholic fatty liver disease among adults in the United States, 1999-2016. Clin Gastroenterol Hepatol. 2022;20(12):2838-2847.PubMed Google Scholar Crossref

Cusi K , Isaacs S , Barb D , et al. American Association of Clinical Endocrinology clinical practice guideline for the diagnosis and management of nonalcoholic fatty liver disease in primary care and endocrinology clinical settings. Endocr Pract. 2022;28(5):528-562.PubMed Google Scholar Crossref

Lee J , Vali Y , Boursier J , et al. Prognostic accuracy of FIB-4, NAFLD fibrosis score and APRI for NAFLD-related events. Liver Int. 2021;41(2):261-270.PubMed Google Scholar Crossref

Chan WK , Treeprasertsuk S , Goh GB , et al. Optimizing use of nonalcoholic fatty liver disease fibrosis score, Fibrosis-4 Score, and liver stiffness measurement to identify patients with advanced fibrosis. Clin Gastroenterol Hepatol. 2019;17(12):2570-2580.PubMed Google Scholar Crossref

Mantovani A , Csermely A , Petracca G , et al. Non-alcoholic fatty liver disease and risk of fatal and non-fatal cardiovascular events. Lancet Gastroenterol Hepatol. 2021;6(11):903-913.PubMed Google Scholar Crossref

Bril F , Sanyal A , Cusi K . Metabolic syndrome and its association with nonalcoholic steatohepatitis. Clin Liver Dis. 2023;27(2):187-210.PubMed Google Scholar Crossref

Newsome PN , Buchholtz K , Cusi K , et al. A placebo-controlled trial of subcutaneous semaglutide in nonalcoholic steatohepatitis. N Engl J Med. 2021;384(12):1113-1124.PubMed Google Scholar Crossref

Musso G , Cassader M , Paschetta E , Gambino R . Thiazolidinediones and advanced liver fibrosis in nonalcoholic steatohepatitis. JAMA Intern Med. 2017;177(5):633-640. PubMed Google Scholar Crossref

Rinella ME , Neuschwander-Tetri BA , Siddiqui MS , et al. AASLD practice guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835.PubMed Google Scholar Crossref

Rinella ME , Lazarus JV , Ratziu V , et al. A multi-society Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol. Published online June 20, 2023.PubMed Google Scholar

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.