Original scientific paper
https://doi.org/10.20471/acc.2021.60.s1.03
Croatian guidelines for the diagnosis and treatment of nonalcoholic fatty liver disease
Lucija Virović Jukić
orcid.org/0000-0002-6350-317X
; School of Medicine, University of Zagreb, Zagreb, Croatia; Sestre milosrdnice University Hospital Center, Zagreb, Croatia; Croatian Society of Gastroenterology, Zagreb, Croatia
Ivica Grgurević
; School of Medicine, University of Zagreb, Zagreb, Croatia; Croatian Society of Gastroenterology, Zagreb, Croatia; Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia; Dubrava University Hospital, Zagreb, Croatia
Ivana Mikolašević
; Croatian Society of Gastroenterology, Zagreb, Croatia; School of Medicine, University of Rijeka, Rijeka, Croatia; Rijeka University Hospital Center, Rijeka, Croatia
Tajana Filipec Kanižaj
; School of Medicine, University of Zagreb, Zagreb, Croatia; Croatian Society of Gastroenterology, Zagreb, Croatia; Merkur University Hospital, Zagreb, Croatia;
Sandra Milić
; Croatian Society of Gastroenterology, Zagreb, Croatia; School of Medicine, University of Rijeka, Rijeka, Croatia; Rijeka University Hospital Center, Rijeka, Croatia
Anna Mrzljak
; School of Medicine, University of Zagreb, Zagreb, Croatia; Croatian Society of Gastroenterology, Zagreb, Croatia; Zagreb University Hospital Center, Zagreb, Croatia
Marina Premužić
; Croatian Society of Gastroenterology, Zagreb, Croatia; Zagreb University Hospital Center, Zagreb, Croatia
Irena Hrstić
; Croatian Society of Gastroenterology, Zagreb, Croatia; School of Medicine, University of Rijeka, Rijeka, Croatia; Pula General Hospital, Pula, Croatia
Ivana Knežević Štromar
; Croatian Society of Gastroenterology, Zagreb, Croatia; Zagreb University Hospital Center, Zagreb, Croatia
Neven Ljubičić
; School of Medicine, University of Zagreb, Zagreb, Croatia; Sestre milosrdnice University Hospital Center, Zagreb, Croatia; Croatian Society of Gastroenterology, Zagreb, Croatia; School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Rajko Ostojić
; School of Medicine, University of Zagreb, Zagreb, Croatia; Croatian Society of Gastroenterology, Zagreb, Croatia; Zagreb University Hospital Center, Zagreb, Croatia
Sanja Stojsavljević Shapeski
; Sestre milosrdnice University Hospital Center, Zagreb, Croatia; Croatian Society of Gastroenterology, Zagreb, Croatia
Vjekoslava Amerl-Šakić
; Vjekoslava Amerl-Šakić Family Medicine Practice, Zagreb, Croatia; Coordination of the Croatian Family Medicine for Prevention Programs, Zagreb, Croatia
Nina Bašić Marković
; School of Medicine, University of Rijeka, Rijeka, Croatia; Nina Bašić Marković Family Medicine Practice, Rijeka, Croatia; Society of Teachers of General-Family Medicine, Rijeka, Croatia
Marko Rađa
; Healthcare Center of the Split-Dalmatia County, Split, Croatia; Croatian Family Medicine Society, Split, Croatia
Dragan Soldo
; School of Medicine, University of Zagreb, Zagreb, Croatia; Zagreb-Center Healthcare Center, Zagreb, Croatia; Andrija Štampar School of Public Health, Zagreb, Croatia; Croatian Society of Family Physicians, Croatian Medical Association, Zagreb, Croatia
Nikola Sobočan
; School of Medicine, University of Zagreb, Zagreb, Croatia; Croatian Society of Gastroenterology, Zagreb, Croatia; Merkur University Hospital, Zagreb, Croatia
Miloš Lalovac
; Croatian Society of Gastroenterology, Zagreb, Croatia; Merkur University Hospital, Zagreb, Croatia
Željko Puljiz
; Croatian Society of Gastroenterology, Zagreb, Croatia; School of Medicine, University of Split, Split, Croatia; Split University Hospital Center, Split, Croatia
Kristian Podrug
; Croatian Society of Gastroenterology, Zagreb, Croatia; Split University Hospital Center, Split, Croatia
Dinko Ladić
; Croatian Society of Gastroenterology, Zagreb, Croatia; Osijek University Hospital Center, Osijek, Croatia
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a term describing excessive accumulation
of fat in hepatocytes, and is associated with metabolic syndrome and insulin resistance. NAFLD
prevalence is on increase and goes in parallel with the increasing prevalence of metabolic syndrome
and its components. That is why Croatian guidelines have been developed, which cover the screening
protocol for patients with NAFLD risk factors, and the recommended diagnostic work-up and treatment
of NAFLD patients. NAFLD screening should be done in patients with type 2 diabetes mellitus,
or persons with two or more risk factors as part of metabolic screening, and is carried out by
noninvasive laboratory and imaging methods used to detect fibrosis. Patient work-up should exclude
the existence of other causes of liver injury and determine the stage of fibrosis as the most important
factor in disease prognosis. Patients with initial stages of fibrosis continue to be monitored at the
primary healthcare level with the management of metabolic risk factors, dietary measures, and increased
physical activity. Patients with advanced fibrosis should be referred to a gastroenterologist/
hepatologist for further treatment, monitoring, and detection and management of complications.
Keywords
Nonalcoholic fatty liver disease (NAFLD); Nonalcoholic steatohepatitis (NASH); Metabolic syndrome; Screening; Noninvasive methods; Hepatocellular carcinoma
Hrčak ID:
275610
URI
Publication date:
1.12.2021.
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