Description

This special episode of Healthier World designed to give you Instant Insights discusses the importance of screening and managing fatty liver disease, a condition affecting 1 in 3 Americans and over 70% of patients with type 2 diabetes. The episode covers the transition from the term NAFLD to MASLD, discusses the AACE-recommended testing algorithm for MASLD using the fibrosis-4 (FIB-4) score and the enhanced liver fibrosis (ELF) and highlights the importance of early identification and intervention for proper management of underlying metabolic conditions.

This episode will

• Review the implications of the shift in terminology from NAFLD to MASLD (1:00)
• Discuss the progression of MASLD (1:25)
• Walk through the testing algorithm for MASLD, starting with the first-line screening assessment using the FIB-4 and when the follow up with the ELF score is recommended (2:30)
• Highlight the importance of early identification and prevention in managing MASLD and comorbid cardiometabolic conditions (5:45)

To learn more, please review the additional resources below for information on our cardiovascular, metabolic, endocrine, and wellness offerings as well as educational resources and insights from our team of experts. At Quest Diagnostics, we are committed to providing you with results and insights to support your clinical decisions.

Date: October 2025

Speaker(s):  Maeson Latsko, PhD

Contributor(s): Maeson Latsko, PhD; Trisha Winchester, PhD; Millicent Kee, MSN, FNP-BC

Additional Resources

Quest Diagnostics Clinical Education Center [Link]

ELF test detail

FIB4 test summary

2022 AACE algorithm for fatty liver assessment

Ordering information:

CMP + Fib4

Enhanced Liver Fibrosis Score

References:  

Ciardullo S, Vergani M, Perseghin G. Nonalcoholic fatty liver disease in patients with type 2 diabetes: Screening, Diagnosis, and Treatment. J Clin Med. 2023;12(17):5597. doi:10.3390/jcm12175597

Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, et al. AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease. Hepatology. 2023;77(5):1797-1835. doi:10.1097/HEP.0000000000000323

Cusi K, Isaacs S, Barb D, et al. American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocr Pract. 2022;28(5):528-562. doi:10.1016/j.eprac.2022.03.010

Stern C, Castera L. Identification of high-risk subjects in nonalcoholic fatty liver disease. Clin Mol Hepatol. 2023;29(Suppl):S196-S206. doi:10.3350/cmh.2022.0431