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Clinical guidelines of non-alcoholic fatty liver disease: A systematic review

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To perform a systematic review to grade guidelines and present recommendations for clinical management of non-alcoholic fatty liver disease (NAFLD).

Methods: A database search was conducted on PubMed for guidelines published before May 2016, supplemented by reviewing relevant websites. The Appraisal of Guidelines for Research and Evaluation (ARGEE) Instrument II was a tool designed to appraise the methodological rigor and transparency in which a clinical guideline is developed and it is used internationally. It was used to appraise the quality of guidelines in this study. The inclusion criteria include: clinical NAFLD guidelines for adults, published in English, and released by governmental agencies or key organizations.

Results: Eleven guidelines were included in this study. Since 2007, guidelines have been released in Asia (3 in China, 1 in South Korea, and 1 in Japan), Europe (1 in Italy), America (1 in United States and 1 in Chile) and three international agencies [European associations joint, Asia-Pacific Working Party and World Gastroenterology Organization (WGO)]. Using the ARGEE II instrument, we found US 2012 and Europe 2016 had the highest scores, especially in the areas of rigor of development and applicability. Additionally, Italy 2010 and Korea 2013 also presented comprehensive content, rigorous procedures and good applicability. And WGO 2014 offered various algorithms for clinical practice. Lastly, a practical algorithm for the clinical management was developed, based on the recommended guidelines.

Conclusion: This is the first systematic review of NAFLD guidelines. It may yield insights for physicians and policy-makers in the development and application of guidelines.

No MeSH data available.


Related in: MedlinePlus

Clinical algorithm for the diagnosis and management of non-alcoholic fatty liver disease in adults. The algorithm was developed according to United States 12[1], WGO 14[13] and Europe 16[2]. 1H-MRS: Proton magnetic resonance spectroscopy; ALT: Alanine transaminase; AST: Aspartate transaminase; BMI: Body mass index; CT: Computed tomography; FPG: Fasting plasma glucose; FXR: Farnesoid X receptor; GGT: Gamma-glutamyltransferase; HbA1c: Hemoglobin a1c; HOMA-IR: Homeostasis model assessment of insulin resistance; MRI: Magnetic resonance imaging; WHR: Waist-to-hip ratio; WGO: World Gastroenterology Organization; NAFLD: Non-alcoholic fatty liver disease.
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Figure 3: Clinical algorithm for the diagnosis and management of non-alcoholic fatty liver disease in adults. The algorithm was developed according to United States 12[1], WGO 14[13] and Europe 16[2]. 1H-MRS: Proton magnetic resonance spectroscopy; ALT: Alanine transaminase; AST: Aspartate transaminase; BMI: Body mass index; CT: Computed tomography; FPG: Fasting plasma glucose; FXR: Farnesoid X receptor; GGT: Gamma-glutamyltransferase; HbA1c: Hemoglobin a1c; HOMA-IR: Homeostasis model assessment of insulin resistance; MRI: Magnetic resonance imaging; WHR: Waist-to-hip ratio; WGO: World Gastroenterology Organization; NAFLD: Non-alcoholic fatty liver disease.

Mentions: Figure 3 presented a clinical algorithm for the diagnosis and management of NAFLD in adults. Generally, the procedure of clinical practice includes diagnosis, assessment, and management.


Clinical guidelines of non-alcoholic fatty liver disease: A systematic review
Clinical algorithm for the diagnosis and management of non-alcoholic fatty liver disease in adults. The algorithm was developed according to United States 12[1], WGO 14[13] and Europe 16[2]. 1H-MRS: Proton magnetic resonance spectroscopy; ALT: Alanine transaminase; AST: Aspartate transaminase; BMI: Body mass index; CT: Computed tomography; FPG: Fasting plasma glucose; FXR: Farnesoid X receptor; GGT: Gamma-glutamyltransferase; HbA1c: Hemoglobin a1c; HOMA-IR: Homeostasis model assessment of insulin resistance; MRI: Magnetic resonance imaging; WHR: Waist-to-hip ratio; WGO: World Gastroenterology Organization; NAFLD: Non-alcoholic fatty liver disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037092&req=5

Figure 3: Clinical algorithm for the diagnosis and management of non-alcoholic fatty liver disease in adults. The algorithm was developed according to United States 12[1], WGO 14[13] and Europe 16[2]. 1H-MRS: Proton magnetic resonance spectroscopy; ALT: Alanine transaminase; AST: Aspartate transaminase; BMI: Body mass index; CT: Computed tomography; FPG: Fasting plasma glucose; FXR: Farnesoid X receptor; GGT: Gamma-glutamyltransferase; HbA1c: Hemoglobin a1c; HOMA-IR: Homeostasis model assessment of insulin resistance; MRI: Magnetic resonance imaging; WHR: Waist-to-hip ratio; WGO: World Gastroenterology Organization; NAFLD: Non-alcoholic fatty liver disease.
Mentions: Figure 3 presented a clinical algorithm for the diagnosis and management of NAFLD in adults. Generally, the procedure of clinical practice includes diagnosis, assessment, and management.

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To perform a systematic review to grade guidelines and present recommendations for clinical management of non-alcoholic fatty liver disease (NAFLD).

Methods: A database search was conducted on PubMed for guidelines published before May 2016, supplemented by reviewing relevant websites. The Appraisal of Guidelines for Research and Evaluation (ARGEE) Instrument II was a tool designed to appraise the methodological rigor and transparency in which a clinical guideline is developed and it is used internationally. It was used to appraise the quality of guidelines in this study. The inclusion criteria include: clinical NAFLD guidelines for adults, published in English, and released by governmental agencies or key organizations.

Results: Eleven guidelines were included in this study. Since 2007, guidelines have been released in Asia (3 in China, 1 in South Korea, and 1 in Japan), Europe (1 in Italy), America (1 in United States and 1 in Chile) and three international agencies [European associations joint, Asia-Pacific Working Party and World Gastroenterology Organization (WGO)]. Using the ARGEE II instrument, we found US 2012 and Europe 2016 had the highest scores, especially in the areas of rigor of development and applicability. Additionally, Italy 2010 and Korea 2013 also presented comprehensive content, rigorous procedures and good applicability. And WGO 2014 offered various algorithms for clinical practice. Lastly, a practical algorithm for the clinical management was developed, based on the recommended guidelines.

Conclusion: This is the first systematic review of NAFLD guidelines. It may yield insights for physicians and policy-makers in the development and application of guidelines.

No MeSH data available.


Related in: MedlinePlus