Non-alcoholic fatty liver disease (NAFLD) is a mainly preventable chronic disease affecting over 5.5 million Australians. General practitioners (GPs) have a major role in the detection and management of NAFLD patients.
Patients who are over 50 years of age, with type 2 diabetes mellitus or the metabolic syndrome are at risk of NAFLD. While lifestyle modification with management of weight and metabolic risk factors remains the cornerstone of NAFLD treatment, GPs have a key role in identifying patients who are at risk of significant liver disease (e.g. advanced fibrosis or cirrhosis) and may require specialist referral for further evaluation and or management. Hospital specialists other than gastroenterologists and hepatologists also have a key role in identifying and managing patients with NAFLD. However the optimal strategy to screen for advanced fibrosis in NAFLD remains under discussion, and in Australia, there are no current guidelines for NAFLD management. This project is assessing the prevalence of NAFLD and advanced fibrosis in primary care and in patients with type 2 diabetes. We are also examining pragmatic approaches to screening for NAFLD in primary care, using non-invasive serum biomarkers and transient elastography.