Commentary
G. Besutti et al. aimed to evaluate the feasibility and efficiency of a guidelines-compliant NAFLD assessment algorithm in patients with newly diagnosed type 2 diabetes. Consecutive patients newly diagnosed with T2D without coexisting liver disease or excessive alcohol consumption were enrolled. They were stratified based on liver enzymes, fatty liver index, ultrasound, fibrosis scores and liver stiffness measurement. Referral rates and positive predictive values (PPVs) for histological NASH and significant fibrosis were evaluated.
For the authors, NAFLD guidelines showed several limitations when applied to type 2 diabetes patients. Referral rates were up to 67% to the hepatologist and 17.5% to liver biopsy. Positive predictive values of referrals for NASH with significant fibrosis were low.
