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)

How to screen?

• Order CBC + Hepatic Function Panel
• Calculate Fib4 Score (.fib4)

Next step?

• If 1.3, refer for FibroScan
• If >65 yo AND Fib4 > 2.67, refer for FibroScan

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)

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