Nonalcoholic fatty liver disease (NAFLD) affects about 37% of adults in the United States and up to 70% of individuals with type 2 diabetes (T2D). NAFLD encompasses a spectrum from simple fatty liver to nonalcoholic steatohepatitis (NASH), which can lead to more severe liver complications like fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). NAFLD is closely linked to metabolic disorders such as obesity, insulin resistance, and cardiovascular disease, with its prevalence expected to increase alongside rising obesity rates.

In response to this growing health challenge, the American Gastroenterological Association (AGA) assembled a multidisciplinary task force to develop the NAFLD/NASH Clinical Care Pathway. This Pathway provides comprehensive guidance from screening and diagnosis to treatment, aiming to streamline care for patients at risk of significant fibrosis. The approach emphasizes lifestyle changes, particularly weight loss, as the primary intervention, alongside pharmacological options like pioglitazone and GLP-1 receptor agonists for those with more advanced disease. The Pathway also suggests using non-invasive diagnostic tools, such as the Fibrosis-4 (FIB-4) score and liver stiffness measurements, to identify patients needing further evaluation or specialist referral.

Reference: Kanwal F, Shubrook JH, Adams LA, et al. Clinical Care Pathway for the Risk Stratification and Management of Patients With Nonalcoholic Fatty Liver Disease. Gastroenterology. 2021 Nov;161(5):1657-1669. doi: 10.1053/j.gastro.2021.07.049. Epub 2021 Sep 20. PMID: 34602251; PMCID: PMC8819923.