MASLD/MASH Screening and Diagnosis

CE / CME

MASLD/MASH Screening and Diagnosis

Physician Assistants/Physician Associates: 0.50 AAPA Category 1 CME credit

Nurses: 0.50 Nursing contact hour

Physicians: maximum of 0.50 AMA PRA Category 1 Credit

Released: December 29, 2023

Expiration: December 28, 2024

Activity

Progress
1 2
Course Completed

References

  1. Rinella ME, Lazarus JV, Ratziu V, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatology. 2023;78:1966-1986.
  2. Younossi ZM. Non-alcoholic fatty liver disease – a global public health perspective. J Hepatol. 2019;70:531-544.
  3. Kabbany MN, Conjeevaram Selvakumar PK, Watt K, et al. Prevalence of nonalcoholic steatohepatitis-associated cirrhosis in the United States: an analysis of National Health and Nutrition Examination Survey Data. Am J Gastroenterol. 2017;112:581-587.
  4. de Alwis NM, Anstee QM, Day CP. How to diagnose nonalcoholic fatty liver disease. Dig Dis. 2016;34(suppl 1):19-26.
  5. Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67:328-357.
  6. Newsome PN, Cramb R, Davison SM, et al. Guidelines on the management of abnormal liver blood tests. Gut. 2018;67:6-19.
  7. Angulo P, Kleiner DE, Dam-Larsen S, et al. Liver fibrosis, but no other histologic features, is associated with long-term outcomes of patients with nonalcoholic fatty liver disease. Gastroenterology. 2015;149:389-97.e10.
  8. Sanyal AJ, Harrison SA, Ratziu V, et al. The natural history of advanced fibrosis due to nonalcoholic steatohepatitis: data from the simtuzumab trials. Hepatology. 2019;70:1913-1927.
  9. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002;346:1221-1231.
  10. Caussy C, Soni M, Cui J, et al. Nonalcoholic fatty liver disease with cirrhosis increases familial risk for advanced fibrosis. J Clin Invest. 2017;127:2697-2704.
  11. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol. 2016;64:1388-1402.
  12. American Diabetes Association. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Medical Care in Diabetes-2019. Diabetes Care. 2019;42(suppl 1):S34-S45.
  13. Rockey DC, Caldwell SH, Goodman ZD, et al; American Association for the Study of Liver Diseases. Liver biopsy. Hepatology. 2009;49:1017-1044.
  14. Kleiner DE, Brunt EM, Van Natta M, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology. 2005;41:1313-1321.
  15. European Association for Study of Liver; Asociacion Latinoamericana para el Estudio del Higado. EASL-ALEH Clinical Practice Guidelines: non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63:237-264.
  16. Sigrist RMS, Liau J, Kaffas AE, et al. Ultrasound elastography: review of techniques and clinical applications. Theranostics. 2017;7:1303-1329.
  17. Jayaswal ANA, Levick C, Selvaraj EA, et al. Prognostic value of multiparametric magnetic resonance imaging, transient elastography and blood-based fibrosis markers in patients with chronic liver disease. Liver Int. 2020;40:3071-3082.
  18. Alkhouri N, McCullough AJ. Noninvasive diagnosis of NASH and liver fibrosis within the spectrum of NAFLD. Gastroenterol Hepatol (N Y). 2012;8:661-668.
  19. MD Calc. NAFLD score. mdcalc.com./calc/3081/nafld-non-alcoholic-fatty-liver-disease-fibrosis-score. Accessed December 26, 2023.
  20. MD Calc. FIB-4 index. mdcalc.com./calc/2200/fibrosis-4-fib-4-index-liver-fibrosis. Accessed December 26, 2023.
  21. Shah AG, Lydecker A, Murray K, et al. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009;7:1104-1112.
  22. Harrison SA, Abdelmalek MF, Diehl AM, et al. Prospective validation of the enhanced liver fibrosis (ELF) test for the prediction of disease progression in patients with nonalcoholic steatohepatitis (NASH) and advanced fibrosis. Presented at: American Association for the Study of Liver Diseases The Liver Meeting 2017; October 20-24, 2017. Poster 2122.
  23. Vuppalanchi R, Siddiqui MS, Van Natta ML, et al. Performance characteristics of vibration-controlled transient elastography for evaluation of nonalcoholic fatty liver disease. Hepatology. 2018;67:134-144.
  24. Hashemi SA, Alavian SM, Gholami-Fesharaki M. Assessment of transient elastography (FibroScan) for diagnosis of fibrosis in non-alcoholic fatty liver disease: a systematic review and meta-analysis. Caspian J Intern Med. 2016;7:242-252.
  25. Kemp W, Roberts S. FibroScan and transient elastography. Aust Fam Physician. 2013;42:468-471.
  26. Robic MA, Procopet B, Métivier S, et al. Liver stiffness accurately predicts portal hypertension related complications in patients with chronic liver disease: a prospective study. J Hepatol. 2011;55:1017-1024.
  27. Ferraioli G, Tinelli C, Dal Bello B, et al. Accuracy of real-time shear wave elastography for assessing liver fibrosis in chronic hepatitis C: a pilot study. Hepatology. 2012;56:2125-2133.
  28. Loomba R, Wolfson T, Ang B, et al. Magnetic resonance elastography predicts advanced fibrosis in patients with nonalcoholic fatty liver disease: a prospective study [published correction appears in Hepatology. 2015;62:1646]. Hepatology. 2014;60:1920-1928.
  29. Younossi ZM, Lawitz E, Alkhouri N, et al. Algorithms using noninvasive tests can accurately identify patients with advanced fibrosis due to NASH: data from the STELLAR clinical trials. Presented at: American Association for the Study of Liver Diseases The Liver Meeting 2018; November 9-13, 2018. Abstract LB-10.
  30. Anstee QM, Lawitz EJ, Alkhouri N, et al. Noninvasive tests accurately identify advanced fibrosis due to NASH: baseline data from the STELLAR trials. Hepatology. 2019;70:1521-1530.
  31. Hannah WN Jr, Harrison SA. Effect of weight loss, diet, exercise, and bariatric surgery on nonalcoholic fatty liver disease. Clin Liver Dis. 2016;20:339-350.
  32. Lassailly G, Caiazzo R, Ntandja-Wandji LC, et al. Bariatric surgery provides long-term resolution of nonalcoholic steatohepatitis and regression of fibrosis. Gastroenterology. 2020;159:1290-1301.e5.
  33. Verrastro O, Panunzi S, Castagneto-Gissey L, et al. Bariatric-metabolic surgery versus lifestyle intervention plus best medical care in non-alcoholic steatohepatitis (BRAVES): a multicentre, open-label, randomized trial. Lancet. 2023;401:1786-1797.
  34. Sanyal AJ, Chalasani N, Kowdley KV, et al. Pioglitazone, vitamin E, or placebo for nonalcoholic steatohepatitis. N Engl J Med. 2010;362:1675-1685.
  35. Newsome PN, Buchholtz K, Cusi K, et al. a placebo-controlled trial of subcutaneous semaglutide in nonalcoholic steatohepatitis. N Engl J Med. 2021;384:1113-1124.