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General practice Terapia 2021, 11 ( 406 ) :  78  -  86

Diagnostics of liver diseases in primary healthcare based on tests included in the 40+ prophylactic program

Summary: The 40 Plus prophylactic program recently introduced by the Polish Ministry of Health provides a convenient possibility to screen for chronic liver disorders in the general population. The inclusion of ALT, AST and GGT not only shows parenchymal/toxic liver injury but may also be used for the assessment of liver fibrosis using simple noninvasive formulas, including APRI or FIB-4 with sensitivity exceeding 70‒80% for liver cirrhosis. Furthermore, the article suggests a diagnostic algorithm based on anamnesis, simple biochemistry with the addition of abdominal ultrasonography and FibroScan in selected cases, allowing for the precise selection of candidates for further consultation in outpatient hematology. The application of noninvasive markers and modalities, but also basic therapeutic approaches in the most prevalent chronic liver disorders, including MAFLD (metabolic associated fatty liver disease), are discussed in more detail in the article.
Keywords: liver, fatty liver, liver function tests, cirrhosis, liver elastography

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