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.
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