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Revista Portuguesa de Medicina Geral e Familiar
Print version ISSN 2182-5173
Abstract
SAPAGE, Sara. Non-alcoholic fatty liver disease in primary health care. Rev Port Med Geral Fam [online]. 2023, vol.39, n.6, pp.582-587. Epub Dec 31, 2023. ISSN 2182-5173. https://doi.org/10.32385/rpmgf.v39i6.13546.
Introduction:
The new epidemic of chronic liver disease is related to non-alcoholic fatty liver disease, which is increasing in parallel with the increase in obesity worldwide. The global prevalence is currently estimated at 24% and is more common in males. Most of these patients can be followed up in primary care, however, recent studies have shown insufficient knowledge about this pathology among primary care physicians and difficulty in identifying patients with significant fibrosis who need intervention on the part of the gastroenterologist.
Objective:
The aim of this work is to review the approach to non-alcoholic fatty liver disease in primary health care.
Methods:
To carry out this review article, a bibliographic search was carried out in the PubMed database in October 2021, using the MeSH terms ‘non-alcoholic fatty liver’ and ‘primary care’. Articles published between 2010 and 2021 were selected, written in Portuguese, English, or Spanish, and whose full text was available. One hundred and twenty-two results were obtained, considering in the final phase that only 22 fit the study objectives.
Results:
Patients with this identified pathology should be evaluated for the stage of liver fibrosis, as this is the most difficult stage. Patients with advanced fibrosis are at risk of developing cirrhosis and hepatocellular carcinoma. There are numerous methods for diagnosing fibrosis in patients with diagnosed non-alcoholic fatty liver disease that can be applied in primary health care due to the use of serum values that are easy to obtain and inexpensive, allowing the calculation of easily accessible scores. Of the studied scores, they are recommended for the detection of advanced fibrosis FIB-4 and the NFS.
Conclusion:
The suggestion of this study for approaching this pathology in primary health care involves the creation of a follow-up algorithm and referral of patients according to the values obtained by calculating the scores and clinical criteria.
Keywords : Non-alcoholic fatty liver; Primary health care.
