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Viral Hepatitis and Liver Disease

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Non-Alcoholic Fatty Liver Diagnosis

for Health Care Providers

Diagnosis - Non-Alcoholic Fatty Liver

Identifying non-alcoholic fatty liver

Does this patient have NAFL? In patients with metabolic syndrome, obesity, and/or diabetes, NAFL is likely present if there is:

  • fatty liver on imaging
  • modest or no alcohol use, whether or not ALT is elevated
  • no hepatitis B or C or secondary causes, such as parenteral nutrition, or culprit medications (e.g., corticosteroids, methotrexate, diltiazem, amiodarone, tamoxifen, highly active antiretroviral therapy)

Metabolic syndrome

Metabolic syndrome is diagnosed by 3 of the following 5 criteria:

  • blood pressure ≥130 mmHg systolic or ≥85 mmHg diastolic (or on treatment)
  • fasting glucose ≥100 mg/dl (or on treatment)
  • triglycerides ≥150 mg/dl (or on treatment)
  • HDL cholesterol <40 mg/dl in men or <50 mg/dl in women (or on treatment)
  • waist circumference ≥40 inches (102 cm) in men or ≥35 inches (88 cm) in women

References

The Diagnosis and Management of Non-Alcoholic Fatty Liver DiseaseLink will take you outside the VA website. VA is not responsible for the content of the linked site.
Practice Guidance from the American Association for the Study of Liver Diseases; Hepatology, 2018