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Who to screen for NAFLD?
- Risk factors: BMI > 30, T2DM, HTN, HLD
- Known steatosis on imaging
- History of abnormal liver enzymes (ALT > 25 (for females), >30 (for males)
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How to screen?
- Order CBC + Hepatic Function Panel
- Calculate Fib4 Score (.fib4)
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Next step?
- If 1.3, refer for FibroScan
- If >65 yo AND Fib4 > 2.67, refer for FibroScan
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Can you refer to FibroScan without elevated Fib4?
- Yes, if ALT > 25 (for females), >30 (for males)
- Yes, if known steatosis on prior imaging (e.g., on abdominal ultrasound)
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How to refer?
- Order 'Referral for Fibroscan' and email ILMAdmin@mountsinai.org
- FibroScan takes place on 8th Floor CAM East (they will have to fast 2-3 hours prior)
- Patients can call 212-241-7270 for an appointment
- They can also walk in from 8am-4pm (except on Tuesdays) without an appointment