https://pubmed.ncbi.nlm.nih.gov/35899429/ NAFLD

Acta Paediatr. 2022 Jul 28.
doi: 10.1111/apa.16502. Online ahead of print

Evaluation of the feasibility of screening for paediatric non-alcoholic fatty liver disease

Laura Draijer 1 2 3, Maaike Voorhoeve 1, Amsterdam Paediatric Obesity Collaboration; Marc Benninga 1, Bart Koot 1
Collaborators, Affiliations expand
PMID: 35899429

DOI: 10.1111/apa.16502
Abstract
Aim: To evaluate the feasibility of screening for non-alcoholic fatty liver disease (NAFLD) in clinical practice and the acceptance of a screening strategy, and to identify factors that determine compliance.
Methods: A screening protocol, based on alanine aminotransferase (ALT) measurement and introduced to healthcare workers of Dutch outpatient obesity clinics in 2017, was evaluated. Medical files of children who visited the largest outpatient obesity clinic between 2017 and 2020 were evaluated. Focus group discussions (FGDs) were conducted with 14 healthcare workers who had been using the screening protocol.

Results: Screening for NAFLD was performed in 477/571 (84%) of the children. Loss to follow-up was the major reason for inadequate screening. Follow-up was performed in 81/134 children with an abnormal screening result (61%). The FGDs indicated thirteen barriers for screening, regarding guideline- and knowledge-related issues.

Conclusion: Screening for NAFLD was performed in the vast majority of the children. However, adherence to the guideline after an abnormal initial screening result needs to be improved. This can be achieved by improving loss of follow-up of patients and physicians' awareness on relevance of mildly elevated ALT levels.