Commentary
Early screening and risk stratification for advanced liver fibrosis is critical in primary care and endocrinology clinics to prevent future cirrhosis in groups such as those with insulin resistance and metabolic syndrome, prediabetes or type 2 diabetes mellitus, or in the presence of elevated plasma aminotransferases or steatosis on imaging.
Recent consensus statements recommend risk stratifying for clinically significant fibrosis in primary care and endocrinology clinics with the FIB-4 index, which calculates the risk of hepatic fibrosis from the computation of age, plasma aminotransferases and platelet count.
As pointed out by K. Cusi (University of Florida, Gainesville, USA), “the challenge remains on whether these inexpensive panels can be optimised for fibrosis risk stratification, and which is the best test to follow an initial FIB-4 testing.” Today “a simple test like FIB-4 can efficiently screen and risk-stratify patients and prevent future cirrhosis in many people with obesity or T2DM – within seconds.”
