What is NAFLD/NASH Assessment?
Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are chronic liver disorders caused by excess fat accumulation and inflammation in the liver. Because these conditions often develop silently, structured assessment is important to identify patients at risk for advanced fibrosis, cirrhosis, and related complications. A comprehensive NAFLD/NASH evaluation typically includes a combination of clinical history, laboratory testing, imaging, and in select cases, liver biopsy to determine disease severity and inform treatment.
When NAFLD/NASH Assessment Is Recommended
Assessment may be recommended for patients who have one or more of the following:
- Abnormal liver enzyme results on routine blood work
- Obesity, metabolic syndrome, or insulin resistance
- Type 2 diabetes or prediabetes
- High triglycerides or low HDL cholesterol
- Persistent fatigue, abdominal discomfort, or unexplained liver symptoms
- History of high alcohol intake but inconclusive findings
- Family history of liver disease
- Incidental imaging findings suggestive of fatty liver
How the Assessment Is Performed
Evaluation begins with a physical exam and metabolic laboratory testing, including liver function tests and noninvasive fibrosis scores (such as FIB-4 or NAFLD Fibrosis Score). Imaging techniques like ultrasound, MRI, or transient elastography are used to quantify liver fat and measure fibrosis. In cases where diagnosis is uncertain, or where advanced disease is suspected, a liver biopsy may be recommended to confirm inflammation and scarring.
What to Expect After Testing
Most noninvasive tests require no recovery time, and patients can return to normal activities immediately. If a liver biopsy is performed, mild soreness, activity restrictions, and short-term observation may be required, but recovery generally occurs within one to two days.
What Are the Risks of NAFLD/NASH Assessment
Potential risks vary by test type and may include:
- False positives or false negatives
- Discomfort or anxiety during procedures
- Minor bleeding, pain, or infection following biopsy
What Are the Benefits of NAFLD/NASH Assessment
Key benefits include:
- Early detection of liver disease progression
- Identification of reversible metabolic risk factors
- Ability to tailor lifestyle and medical treatment
- Prevention of liver failure and long-term complications