{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T05:17:52Z","timestamp":1791609472280,"version":"4.3.4"},"reference-count":43,"publisher":"Georg Thieme Verlag KG","issue":"08","license":[{"start":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T00:00:00Z","timestamp":1676419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Ministerium f\u00fcr Wissenschaft, Forschung und Kunst Baden-W\u00fcrttemberg: Klinische Kooperationseinheit Healthy Metabolism, Medizinische Fakult\u00e4t Mannheim, Universit\u00e4t Heidelberg, Mannheim"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Z Gastroenterol"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die Pr\u00e4valenz der Fettlebererkrankung hat in den letzten Jahren auch in Deutschland\n      erheblich zugenommen. Sie geh\u00f6rt mit gesch\u00e4tzten 18 Mio. betroffenen Bundesb\u00fcrgern\n      mittlerweile zu den gro\u00dfen Volkskrankheiten. Sie gilt ferner als ein relevanter unabh\u00e4ngiger\n      Risikofaktor f\u00fcr weitere kardiovaskul\u00e4re Volkskrankheiten wie Herzinfarkt oder Schlaganfall.\n      Schlie\u00dflich beg\u00fcnstigt ein Diabetes mellitus die Entstehung einer Fettleber und eines\n      ung\u00fcnstigeren Verlaufs der Fettlebererkrankung. Vor dem Hintergrund der hohen Pr\u00e4valenz und\n      Komplikationen kommt das deutsche Gesundheitssystem bei der Versorgung dieser Patienten an die\n      Grenzen seiner Ressourcen.<\/jats:p>\n                  <jats:p>Daher ist eine enge Abstimmung und Vernetzung aller an der Behandlung dieser Patienten\n      beteiligten Fachgebiete und Versorgungsbereiche essenziell notwendig. In einem\n      Expertenkonsensus unter Einbindung niedergelassener Kollegen und Krankenhaus\u00e4rzten der\n      Gastroenterologie, Endokrinologie, Kardiologie, Haus\u00e4rzten und Labormedizinern sowie in enger\n      Abstimmung mit Patientenvertretern haben wir ein Konzept der Versorgung dieser Patienten im\n      deutschen Gesundheitssystem entworfen. Darin werden auch notwendige Entwicklungen adressiert.\n      Neben dem Nutzen als praxisnahem Leitfaden soll dies auch die gesundheitspolitische Arbeit\n      unterst\u00fctzen, insbesondere bei der Erarbeitung von praktischen Versorgungsl\u00f6sungen auf\n      medizinischer Ebene.<\/jats:p>","DOI":"10.1055\/a-1957-5671","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T19:02:06Z","timestamp":1676487726000},"page":"1028-1036","source":"Crossref","is-referenced-by-count":2,"title":["Intersektorales Management von Patienten mit unklarer Leberwerterh\u00f6hung und nichtalkoholischer Fettlebererkrankung (NAFLD)"],"prefix":"10.1055","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7953-8927","authenticated-orcid":false,"given":"Andreas","family":"Teufel","sequence":"additional","affiliation":[{"name":"Sektion Hepatologie, Sektion Klinische Bioinformatik, II. Medizinische Klinik, Medizinische Fakult\u00e4t Mannheim, Universit\u00e4t Heidelberg, Mannheim"},{"name":"Medizinische Fakult\u00e4t Mannheim, Klinische Kooperationseinheit Healthy Metabolism, Zentrum f\u00fcr Pr\u00e4ventionsmedizin und Digitale Gesundheit Baden-W\u00fcrttemberg, Universit\u00e4t Heidelberg, Mannheim"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Geier","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, Universit\u00e4tsklinikum W\u00fcrzburg, W\u00fcrzburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Sarrazin","sequence":"additional","affiliation":[{"name":"Med. Klinik 2, St. Josefs Hospital, Wiesbaden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4224-4703","authenticated-orcid":false,"given":"J\u00f6rn M.","family":"Schattenberg","sequence":"additional","affiliation":[{"name":"I. Medizinische Klinik, Universit\u00e4tsmedizin Mainz, Mainz"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achim","family":"Kautz","sequence":"additional","affiliation":[{"name":"Kautz<sup>5<\/sup> gUG, K\u00f6ln"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Dorner","sequence":"additional","affiliation":[{"name":"Kautz<sup>5<\/sup> gUG, K\u00f6ln"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Kramer","sequence":"additional","affiliation":[{"name":"Medizinische Klinik I, Universit\u00e4t zu L\u00fcbeck, L\u00fcbeck, Germany"},{"name":"LADR Der Laborverbund Dr. Kramer & Kollegen, Geesthacht"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Jerysiak","sequence":"additional","affiliation":[{"name":"LADR Der Laborverbund Dr. Kramer & Kollegen, Geesthacht"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodor","family":"Baars","sequence":"additional","affiliation":[{"name":"Praxis f\u00fcr Innere Medizin, Kardiologie, Notfallmedizin, Sportmedizin, haus\u00e4rztliche Versorgung, Essen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bastian","family":"H\u00f6nscheid","sequence":"additional","affiliation":[{"name":"Praxis im \u00c4rztehaus Braunsfeld, K\u00f6ln"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"M\u00fcller-Wieland","sequence":"additional","affiliation":[{"name":"Medizinische Klinik I, Universit\u00e4tsklinikum, RWTH Aachen, Aachen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siegbert","family":"Rossol","sequence":"additional","affiliation":[{"name":"Medizinische Klinik, Krankenhaus Nordwest, Frankfurt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Trautwein","sequence":"additional","affiliation":[{"name":"Medizinische Klinik III, Universit\u00e4tsklinikum, RWTH Aachen, Aachen"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Tacke","sequence":"additional","affiliation":[{"name":"Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Campus Virchow-Klinikum (CVK) und Campus Charit\u00e9 Mitte (CCM), Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6069-7899","authenticated-orcid":false,"given":"Ali","family":"Canbay","sequence":"additional","affiliation":[{"name":"Ruhr-Universit\u00e4t Bochum, Medizinische Klinik, Universit\u00e4tsklinikum Knappschaftskrankenhaus Bochum, Bochum"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,2,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/j.jhep.2018.05.036","article-title":"Modeling NAFLD disease burden in China, France, Germany, Italy, Japan, Spain,\n          United Kingdom, and United States for the period 2016\u20132030","volume":"69","author":"C Estes","year":"2018","journal-title":"J Hepatol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1112","DOI":"10.1007\/s00125-016-3952-1","article-title":"Treatment of patients with type 2 diabetes and non-alcoholic fatty liver disease:\n          current approaches and future directions","volume":"59","author":"K Cusi","year":"2016","journal-title":"Diabetologia"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1111\/jgh.13264","article-title":"Nonalcoholic fatty liver disease is associated with an almost twofold increased\n          risk of incident type 2 diabetes and metabolic syndrome. Evidence from a systematic review\n          and meta-analysis","volume":"31","author":"S Ballestri","year":"2016","journal-title":"J Gastroenterol Hepatol"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20225613","article-title":"The Burden of Hepatocellular Carcinoma in Non-Alcoholic Fatty Liver Disease:\n          Screening Issue and Future Perspectives","volume":"20","author":"G Pennisi","year":"2019","journal-title":"Int J Mol Sci"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1016\/j.jhep.2018.05.011","article-title":"Burden of liver disease in Europe: Epidemiology and analysis of risk factors to\n          identify prevention policies","volume":"69","author":"L Pimpin","year":"2018","journal-title":"J Hepatol"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1899","article-title":"Prevalence and Risk Factors of Advanced Liver Fibrosis in a Population-Based Study\n          in Germany","author":"Y Huber","year":"2022","journal-title":"Hepatol Commun"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"615","DOI":"10.21037\/atm-20-7179","article-title":"Healthcare resource utilization and costs among nonalcoholic fatty liver disease\n          patients in Germany","volume":"9","author":"A Canbay","year":"2021","journal-title":"Ann Transl Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1053\/j.gastro.2013.10.023","article-title":"So you want to be a hepatologist?","volume":"145","author":"BA Luxon","year":"2013","journal-title":"Gastroenterology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2672","DOI":"10.1002\/hep.30251","article-title":"Global Perspectives on Nonalcoholic Fatty Liver Disease and Nonalcoholic\n          Steatohepatitis","volume":"69","author":"Z Younossi","year":"2019","journal-title":"Hepatology"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1055\/a-0981-6484","article-title":"A 2-step fast-track elastometry service for advanced workup of nonalcoholic fatty\n          liver disease (NAFLD) patients \u2013 single-center real-world experience of outpatient\n          clinical practice","volume":"57","author":"M Alsenbesy","year":"2019","journal-title":"Z Gastroenterol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1111\/apt.16016","article-title":"Patterns and predictors of mortality and disease progression among patients with\n          non-alcoholic fatty liver disease","volume":"52","author":"A Canbay","year":"2020","journal-title":"Aliment Pharmacol Ther"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1002\/hep.21669","article-title":"FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. comparison\n          with liver biopsy and fibrotest","volume":"46","author":"A Vallet-Pichard","year":"2007","journal-title":"Hepatology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/j.jhep.2019.06.021","article-title":"The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A\n          systematic review and meta-analysis","volume":"71","author":"ZM Younossi","year":"2019","journal-title":"J Hepatol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"13058","DOI":"10.1038\/srep13058","article-title":"Normal liver enzymes are correlated with severity of metabolic syndrome in a large\n          population based cohort","volume":"5","author":"J Kalsch","year":"2015","journal-title":"Sci Rep"},{"issue":"S 01","key":"ref17","doi-asserted-by":"crossref","first-page":"S156","DOI":"10.1055\/a-1193-3913","article-title":"Diabetes und Fettleber","volume":"15","author":"N Stefan","year":"2020","journal-title":"Diabetologie"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.3390\/cells9112458","article-title":"Significance of Simple Steatosis: An Update on the Clinical and Molecular\n          Evidence","volume":"9","author":"G Mazzolini","year":"2020","journal-title":"Cells"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"S37","DOI":"10.2337\/dc20-S004","article-title":"4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of\n          Medical Care in Diabetes-2020","volume":"43","author":"A American Diabetes","year":"2020","journal-title":"Diabetes Care"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1111\/liv.14669","article-title":"Prognostic accuracy of FIB-4, NAFLD fibrosis score and APRI for NAFLD-related\n          events: A systematic review","volume":"41","author":"J Lee","year":"2021","journal-title":"Liver Int"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"45","DOI":"10.4103\/2249-4863.152252","article-title":"Nonalcoholic Fatty liver disease and risk of diabetes and cardiovascular disease:\n          what is important for primary care physicians?","volume":"4","author":"MH Ahmed","year":"2015","journal-title":"J Family Med Prim Care"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3390\/life11020143","article-title":"FIB-4 First in the Diagnostic Algorithm of Metabolic-Dysfunction-Associated Fatty\n          Liver Disease in the Era of the Global Metabodemic","volume":"11","author":"Y Sumida","year":"2021","journal-title":"Life (Basel)"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1362","DOI":"10.1016\/j.jhep.2022.03.026","article-title":"Impact of non-invasive biomarkers on hepatology practice: Past, present and\n          future","volume":"76","author":"QM Anstee","year":"2022","journal-title":"J Hepatol"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"740","DOI":"10.1038\/ajg.2016.453","article-title":"Age as a Confounding Factor for the Accurate Non-Invasive Diagnosis of Advanced\n          NAFLD Fibrosis","volume":"112","author":"S McPherson","year":"2017","journal-title":"Am J Gastroenterol"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1055\/a-1491-1771","article-title":"Conventional ultrasound for diagnosis of hepatic steatosis is better than\n          believed","author":"CF Dietrich","year":"2021","journal-title":"Z Gastroenterol"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2803","DOI":"10.1016\/j.ultrasmedbio.2021.06.002","article-title":"Quantification of Liver Fat Content with Ultrasound: A WFUMB Position\n          Paper","volume":"47","author":"G Ferraioli","year":"2021","journal-title":"Ultrasound Med Biol"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1002\/hep.24452","article-title":"Diagnostic accuracy and reliability of ultrasonography for the detection of fatty\n          liver: a meta-analysis","volume":"54","author":"R Hernaez","year":"2011","journal-title":"Hepatology"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1136\/gut.2009.203166","article-title":"Enhanced liver fibrosis test can predict clinical outcomes in patients with\n          chronic liver disease","volume":"59","author":"J Parkes","year":"2010","journal-title":"Gut"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1002\/hep4.1700","article-title":"A Dynamic Aspartate-to-Alanine Aminotransferase Ratio Provides Valid Predictions\n          of Incident Severe Liver Disease","volume":"5","author":"F Aberg","year":"2021","journal-title":"Hepatol Commun"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1080\/00365521.2019.1699600","article-title":"Self-testing for liver disease \u2013 response to an online liver test\n          questionnaire","volume":"55","author":"A Kautz","year":"2020","journal-title":"Scand J Gastroenterol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1002\/hep.22090","article-title":"Serum aminotransferase activity and mortality risk in a United States\n          community","volume":"47","author":"TH Lee","year":"2008","journal-title":"Hepatology"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.1053\/j.gastro.2020.07.050","article-title":"Screening for Nonalcoholic Fatty Liver Disease in Persons with Type 2 Diabetes in\n          the United States Is Cost-effective: A Comprehensive Cost-Utility Analysis","volume":"159","author":"M Noureddin","year":"2020","journal-title":"Gastroenterology"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"729","DOI":"10.21037\/atm-20-4354","article-title":"Non-alcoholic fatty liver disease (NAFLD)\/non-alcoholic steatohepatitis\n          (NASH)-related liver fibrosis: mechanisms, treatment and prevention","volume":"9","author":"F Tacke","year":"2021","journal-title":"Ann Transl Med"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1055\/s-0035-1553193","article-title":"S2k Guideline non-alcoholic fatty liver disease","volume":"53","author":"E Roeb","year":"2015","journal-title":"Z Gastroenterol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1055\/s-0033-1355841","article-title":"Diagnosis of and therapy for hepatocellular carcinoma","volume":"51","author":"TF Greten","year":"2013","journal-title":"Z Gastroenterol"},{"key":"ref39","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/j.cgh.2019.11.012","article-title":"GALAD Score Detects Early Hepatocellular Carcinoma in an International Cohort of\n          Patients With Nonalcoholic Steatohepatitis","volume":"18","author":"J Best","year":"2020","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1016\/j.jhep.2015.05.022","article-title":"Expanding consensus in portal hypertension: Report of the Baveno VI Consensus\n          Workshop: Stratifying risk and individualizing care for portal hypertension","volume":"63","author":"R de Franchis","year":"2015","journal-title":"J Hepatol"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"e168","DOI":"10.1055\/a-0928-2800","article-title":"Updated S2k-Guideline \"Complications of liver cirrhosis\". German Society of\n          Gastroenterology (DGVS)","volume":"57","author":"AL Gerbes","year":"2019","journal-title":"Z Gastroenterol"},{"key":"ref42","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jhep.2018.03.024","article-title":"Electronic address eee, European Association for the Study of the L: EASL Clinical\n          Practice Guidelines for the management of patients with decompensated cirrhosis","volume":"69","author":"European Association for the Study of the Liver","year":"2018","journal-title":"J Hepatol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"4079","DOI":"10.3748\/wjg.v22.i16.4079","article-title":"Nonalcoholic fatty liver disease as a multi-systemic disease","volume":"22","author":"H Fotbolcu","year":"2016","journal-title":"World J Gastroenterol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1159\/000514277","article-title":"Co-Medication and Nutrition in Hepatocellular Carcinoma: Potenzially Preventative\n          Strategies in Hepatocellular Carcinoma","volume":"39","author":"A Kusnik","year":"2021","journal-title":"Dig Dis"},{"key":"ref45","doi-asserted-by":"publisher","DOI":"10.3390\/metabo11020073","article-title":"Glucagon-Like Peptide-1 Receptor Agonists for Treatment of Nonalcoholic Fatty\n          Liver Disease and Nonalcoholic Steatohepatitis: An Updated Meta-Analysis of Randomized\n          Controlled Trials","volume":"11","author":"A Mantovani","year":"2021","journal-title":"Metabolites"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1080\/17512433.2021.1917374","article-title":"Effects of anti-diabetic treatments in type 2 diabetes and fatty liver\n          disease","volume":"14","author":"EM Lamos","year":"2021","journal-title":"Expert Rev Clin Pharmacol"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1097\/HCO.0000000000000861","article-title":"Update on cardiovascular risk in nonalcoholic fatty liver disease","volume":"36","author":"MP Johnston","year":"2021","journal-title":"Curr Opin Cardiol"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"2960","DOI":"10.1111\/jgh.15589","article-title":"Liver fibrosis and fatty liver as independent risk factors for cardiovascular\n          disease","volume":"36","author":"N Tamaki","year":"2021","journal-title":"J Gastroenterol Hepatol"}],"container-title":["Zeitschrift f\u00fcr Gastroenterologie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1957-5671.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T14:47:56Z","timestamp":1764168476000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1957-5671"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,15]]},"references-count":43,"journal-issue":{"issue":"08","published-online":{"date-parts":[[2023,8,11]]},"published-print":{"date-parts":[[2023,8]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1957-5671","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0044-2771","1439-7803"],"issn-type":[{"value":"0044-2771","type":"print"},{"value":"1439-7803","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,15]]}}}