From the Guidelines
Non-alcoholic fatty liver disease (NAFLD) monitoring typically involves a combination of laboratory tests, including liver function tests (LFTs) such as alanine aminotransferase (ALT), alkaline phosphatase (ALP), and γ-glutamyltransferase (GGT), as well as biomarkers like the Fibrosis-4 (FIB-4) index and the NAFLD Fibrosis Score (NFS).
Key Laboratory Tests for NAFLD Monitoring
- Liver function tests (LFTs):
- Bilirubin
- Albumin
- Alanine aminotransferase (ALT)
- Alkaline phosphatase (ALP)
- γ-glutamyltransferase (GGT) 1
- Biomarkers for fibrosis:
- Fibrosis-4 (FIB-4) index
- NAFLD Fibrosis Score (NFS) 1
Additional Diagnostic Tools
- Imaging studies: Abdominal ultrasound scan (USS) may be used as part of a liver aetiology screen 1
- Liver biopsy: Remains the gold standard for characterizing liver histological alterations, but is typically reserved for patients at increased risk of having significant histological abnormalities or advanced fibrosis 1 These tests and tools help clinicians assess the severity of NAFLD, monitor disease progression, and identify patients at increased risk of adverse outcomes 1.
From the Research
Laboratory Tests for NAFLD
The following laboratory tests are used to monitor non-alcoholic fatty liver disease (NAFLD):
- Aspartate transaminase (AST) and alanine transaminase (ALT) ratio 2
- AST platelet ratio index (APRI) score 2, 3
- Fibrosis-4 (FIB-4) score 2, 3, 4
- NAFLD fibrosis score (NFS) 3
- Dynamic aspartate-to-alanine aminotransferase ratio (dAAR) 3
- Serum indices, such as gamma-glutamyl transferase, cholesterol, LDL, HDL, triglycerides, and ALP 2
Non-Invasive Tests
Non-invasive tests, such as:
- Fibroscan examinations 2
- Transient elastography (TE) 3
- Ultrasound techniques 5
- Imaging methods, such as CT and MRI scans, can also be used to diagnose and stage NAFLD 5, 6
Blood-Based Non-Invasive Tests
Blood-based non-invasive tests (NITs) are used to evaluate fibrosis and identify patients at risk, including: