Page 15 - I Have Fatty Liver：What Does It Mean and What Should I Do?

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Assessment of Fatty Liver

Blood Test Fribrosis-4

(Liver Function Test) Score

Ultrasound Liver Stiffness
Abdomen Measurement

Assessment Result Action

Normal Repeat ALT and AST
ALT and AST annually

Elevated ▪ US abdomen to ▪ Exclude other causes of
Blood Tests ALT and AST* diagnose fatty liver disease
(e.g. ALT and AST) liver/exclude focal liver ▪ Consider referral to
lesion
Gastroenterologist/
▪ Repeat ALT and AST Hepatologist
after 3 – 6 months
Fibrosis-4 Index Repeat every 2 – 3 years
< 1.3

Fibrosis-4 Scoring Fibrosis-4 Index Refer for liver stiffness Consider referral to
≥ 1.3 measurement Gastroenterologist/
Hepatologist
* Exclude possibility of drug-induced liver injury

Ministry of Health Malaysia. 6th Edition CPG on Management of T2DM 2020.