{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T04:15:20Z","timestamp":1776312920044,"version":"3.50.1"},"reference-count":72,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T00:00:00Z","timestamp":1698710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is the most common liver disease. It has a rapidly growing patient population owing to the increasing prevalence of obesity and type 2 diabetes. Patients with MASLD are primarily treated by family physicians when fibrosis is absent or mild and by gastroenterologists\/hepatologists when fibrosis is more advanced. It is imperative that a system for the appropriate treatment and surveillance of hepatocellular carcinoma be established in order to ensure that highly fibrotic cases are not overlooked among the large number of MASLD patients. Family physicians should check for viral hepatitis, autoimmune hepatitis, alcoholic liver disease, and drug-induced liver disease, and should evaluate fibrosis using NIT; gastroenterologists\/hepatologists should perform liver biopsy, ultrasound elastography (260 units in Japan as of October 2023), and MR elastography (35 units in Japan as of October 2023). This review presents the latest findings in MASLD and the role, accuracy, and clinical use of NIT. It also describes the collaboration between Japanese primary care and gastroenterologists\/hepatologists in Japan in the treatment of liver diseases, including MASLD.<\/jats:p>","DOI":"10.3390\/life13112144","type":"journal-article","created":{"date-parts":[[2023,10,31]],"date-time":"2023-10-31T12:44:03Z","timestamp":1698756243000},"page":"2144","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Frontiers of Collaboration between Primary Care and Specialists in the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Review"],"prefix":"10.3390","volume":"13","author":[{"given":"Koki","family":"Nagai","sequence":"first","affiliation":[{"name":"Gastroenterology Division, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajyuku, Totsuka-ku, Yokohama 245-8575, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuki","family":"Nagai","sequence":"additional","affiliation":[{"name":"Nagai Clinic, 1-7-25 Yokodai, Isogo-ku, Yokohama 235-0045, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michihiro","family":"Iwaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Yokohama City University Hospital, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Yokohama City University Hospital, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6923-365X","authenticated-orcid":false,"given":"Asako","family":"Nogami","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Yokohama City University Hospital, 3-9 Fuku-ura, Kanazawa-ku, Yokohama 236-0004, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanao","family":"Oka","sequence":"additional","affiliation":[{"name":"OkaMedical, 1-19-18-3F Kamiookanishi, Kounan-ku, Yokohama 233-0002, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5666-5218","authenticated-orcid":false,"given":"Satoru","family":"Saito","sequence":"additional","affiliation":[{"name":"Sanno Hospital, 8-10-16 Akasaka, Minato-ku, Tokyo 107-0052, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7815-549X","authenticated-orcid":false,"given":"Masato","family":"Yoneda","sequence":"additional","affiliation":[{"name":"Gastroenterology Division, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajyuku, Totsuka-ku, Yokohama 245-8575, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Rinella, M.E., Lazarus, J.V., Ratziu, V., Francque, S.M., Sanyal, A.J., Kanwal, F., Romero, D., Abdelmalek, M.F., Anstee, Q.M., and Arab, J.P. (2023). A Multi-society Delphi Consensus Statement on New Fatty Liver Disease Nomenclature. Hepatology.","DOI":"10.1097\/HEP.0000000000000520"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Rinella, M.E., Lazarus, J.V., Ratziu, V., Francque, S.M., Sanyal, A.J., Kanwal, F., Romero, D., Abdelmalek, M.F., Anstee, Q.M., and Arab, J.P. (2023). A Multi-society Delphi Consensus Statement on New Fatty Liver Disease Nomenclature. J. Hepatol.","DOI":"10.1097\/HEP.0000000000000520"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1038\/nrgastro.2017.109","article-title":"Global Burden of NAFLD and NASH: Trends, Predictions, Risk Factors and Prevention","volume":"15","author":"Younossi","year":"2018","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1097\/HEP.0000000000000004","article-title":"The Global Epidemiology of Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH): A Systematic Review","volume":"77","author":"Younossi","year":"2023","journal-title":"Hepatology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/HEP.0000000000000351","article-title":"Noninvasive Assessment of Liver Disease Severity in Patients with Nonalcoholic Fatty Liver Disease (NAFLD) and Type 2 Diabetes","volume":"78","author":"Pennisi","year":"2023","journal-title":"Hepatology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4018","DOI":"10.3748\/wjg.v27.i26.4018","article-title":"Viral Hepatitis Update: Progress and Perspectives","volume":"27","author":"Pisano","year":"2021","journal-title":"World J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s00535-020-01754-z","article-title":"Hepatocellular Carcinoma Development in Diabetic Patients: A Nationwide Survey in Japan","volume":"56","author":"Tateishi","year":"2021","journal-title":"J. Gastroenterol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1136\/gutjnl-2020-322786","article-title":"Mortality in Biopsy-Confirmed Nonalcoholic Fatty Liver Disease: Results from a Nationwide Cohort","volume":"70","author":"Simon","year":"2021","journal-title":"Gut"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1002\/hep.29085","article-title":"Increased Risk of Mortality by Fibrosis Stage in Nonalcoholic Fatty Liver Disease: Systematic Review and Meta-analysis","volume":"65","author":"Dulai","year":"2017","journal-title":"Hepatology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1038\/s41395-018-0170-0","article-title":"Non-invasive Diagnosis of Nonalcoholic Fatty Liver Disease","volume":"113","author":"Yoneda","year":"2018","journal-title":"Am. J. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1097\/HEP.0000000000000323","article-title":"AASLD Practice Guidance on the Clinical Assessment and Management of Nonalcoholic Fatty Liver Disease","volume":"77","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.2337\/dc23-S004","article-title":"Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2023","volume":"46","author":"ElSayed","year":"2023","journal-title":"Diabetes Care"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/j.eprac.2022.03.010","article-title":"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)","volume":"28","author":"Cusi","year":"2022","journal-title":"Endocr. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1007\/s00535-021-01796-x","article-title":"Evidence-Based Clinical Practice Guidelines for Nonalcoholic Fatty Liver Disease\/Nonalcoholic Steatohepatitis 2020","volume":"56","author":"Tokushige","year":"2021","journal-title":"J. Gastroenterol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1111\/j.0954-6820.1973.tb19478.x","article-title":"Fatty Liver Persisting for up to 33 Years. A Follow-Up of the inversen-roholm Liver Biopsy Material","volume":"194","author":"Hilden","year":"1973","journal-title":"Acta Med. Scand."},{"key":"ref_16","first-page":"434","article-title":"Nonalcoholic Steatohepatitis: Mayo Clinic Experiences with a Hitherto Unnamed Disease","volume":"55","author":"Ludwig","year":"1980","journal-title":"Mayo Clin. Proc."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S101","DOI":"10.1038\/550S101a","article-title":"Fatty Liver Disease: Turning the Tide","volume":"550","author":"Drew","year":"2017","journal-title":"Nature"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/S0168-8278(98)80073-1","article-title":"Non-alcoholic Steatohepatitis (NASH): A Disease of Emerging Identity and Importance","volume":"29","author":"James","year":"1998","journal-title":"J. Hepatol."},{"key":"ref_19","unstructured":"Berk, J.E., Haubrich, W.S., and Kalser, M.H. (1985). Bockus Gastroenterology, Saunders. [4th ed.]."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1002\/hep.27173","article-title":"Consortium Utility and Appropriateness of the Fatty Liver Inhibition of Progression (FLIP) Algorithm and Steatosis, Activity, and Fibrosis (SAF) Score in the Evaluation of Biopsies of Nonalcoholic Fatty Liver Disease","volume":"60","author":"Bedossa","year":"2014","journal-title":"Hepatology"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1016\/j.jhep.2020.07.045","article-title":"Reply to: Correspondence Regarding \u201cA New Definition for Metabolic Dysfunction-Associated Fatty Liver Disease: An International Expert Consensus Statement\u201d: Bringing Evidence to the NAFLD-MAFLD Debate","volume":"73","author":"Eslam","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1002\/hep.31518","article-title":"Multiple Parallel Hits Hypothesis in Nonalcoholic Fatty Liver Disease: Revisited after a Decade","volume":"73","author":"Tilg","year":"2021","journal-title":"Hepatology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1053\/gast.2001.23256","article-title":"Nonalcoholic Steatohepatitis: Association of Insulin Resistance and Mitochondrial Abnormalities","volume":"120","author":"Sanyal","year":"2001","journal-title":"Gastroenterology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S0261-5614(99)80015-6","article-title":"Non-Alcoholic Fatty Liver: Another Feature of the Metabolic Syndrome?","volume":"18","author":"Camilo","year":"1999","journal-title":"Clin. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.2174\/138161210791208875","article-title":"Insulin Resistance in Nonalcoholic Fatty Liver Disease","volume":"16","author":"Bugianesi","year":"2010","journal-title":"Curr. Pharm. Des."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1172\/JCI34275","article-title":"Contribution of de Novo Fatty Acid Synthesis to Hepatic Steatosis and Insulin Resistance: Lessons from Genetically Engineered Mice","volume":"118","author":"Postic","year":"2008","journal-title":"J. Clin. Investig."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1038\/nrm2391","article-title":"Adipocyte Dysfunctions Linking Obesity to Insulin Resistance and Type 2 Diabetes","volume":"9","author":"Guilherme","year":"2008","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1002\/hep.28985","article-title":"Metabolic and Histological Implications of Intrahepatic Triglyceride Content in Nonalcoholic Fatty Liver Disease","volume":"65","author":"Bril","year":"2017","journal-title":"Hepatology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/S2213-8587(22)00003-1","article-title":"A Global View of the Interplay Between Non-alcoholic Fatty Liver Disease and Diabetes","volume":"10","author":"Stefan","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"155694","DOI":"10.1016\/j.metabol.2023.155694","article-title":"Circulating Hormones in Biopsy-Proven Steatotic Liver Disease and Steatohepatitis: A Multicenter Observational Study","volume":"148","author":"Chrysafi","year":"2023","journal-title":"Metabolism"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.cmet.2012.05.012","article-title":"Hyperresponsivity to Low-Dose Endotoxin During Progression to Nonalcoholic Steatohepatitis Is Regulated by Leptin-Mediated Signaling","volume":"16","author":"Imajo","year":"2012","journal-title":"Cell Metab."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1186\/s13098-023-01085-y","article-title":"Effects of SGLT-2 Inhibitors on Adipose Tissue Distribution in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis of Randomized Controlled Trials","volume":"15","author":"Wang","year":"2023","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1016\/S2213-8587(23)00235-8","article-title":"Mechanisms of Weight Loss-Induced Remission in People with Prediabetes: A Post-hoc Analysis of the Randomised, Controlled, Multicentre Prediabetes Lifestyle Intervention Study (PLIS)","volume":"11","author":"Sandforth","year":"2023","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1002\/hep.23535","article-title":"Increased Fructose Consumption Is Associated with Fibrosis Severity in Patients with Nonalcoholic Fatty Liver Disease","volume":"51","author":"Abdelmalek","year":"2010","journal-title":"Hepatology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/j.jhep.2015.03.032","article-title":"Sugar-Sweetened Beverage, Diet Soda, and Fatty Liver Disease in the Framingham Heart Study Cohorts","volume":"63","author":"Ma","year":"2015","journal-title":"J. Hepatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1002\/hep.24731","article-title":"Association of Coffee and Caffeine Consumption with Fatty Liver Disease, Nonalcoholic Steatohepatitis, and Degree of Hepatic Fibrosis","volume":"55","author":"Molloy","year":"2012","journal-title":"Hepatology"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Kobayashi, T., Iwaki, M., Nakajima, A., Nogami, A., and Yoneda, M. (2022). Current Research on the Pathogenesis of NAFLD\/NASH and the Gut-Liver Axis: Gut Microbiota, Dysbiosis, and Leaky-Gut Syndrome. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms231911689"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Shreya, S., Grosset, C.F., and Jain, B.P. (2023). Unfolded Protein Response Signaling in Liver Disorders: A 2023 Updated Review. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241814066"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"109458","DOI":"10.1016\/j.intimp.2022.109458","article-title":"Role of Endoplasmic Reticulum Stress in Hepatic Glucose and Lipid Metabolism and Therapeutic Strategies for Metabolic Liver Disease","volume":"113","author":"Zheng","year":"2022","journal-title":"Int. Immunopharmacol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1038\/ng.257","article-title":"Genetic Variation in PNPLA3 Confers Susceptibility to Nonalcoholic Fatty Liver Disease","volume":"40","author":"Romeo","year":"2008","journal-title":"Nat. Genet."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1016\/j.jhep.2020.02.020","article-title":"Update on NAFLD Genetics: From New Variants to the Clinic","volume":"72","author":"Valenti","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1038\/ng.2901","article-title":"Exome-Wide Association Study Identifies a TM6SF2 Variant That Confers Susceptibility to Nonalcoholic Fatty Liver Disease","volume":"46","author":"Kozlitina","year":"2014","journal-title":"Nat. Genet."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1002\/hep.28431","article-title":"Global Epidemiology of Nonalcoholic Fatty Liver Disease-Meta-analytic Assessment of Prevalence, Incidence, and Outcomes","volume":"64","author":"Younossi","year":"2016","journal-title":"Hepatology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1007\/s12072-021-10143-4","article-title":"The Epidemiology of NAFLD and Lean NAFLD in Japan: A Meta-analysis with Individual and Forecasting Analysis, 1995\u20132040","volume":"15","author":"Ito","year":"2021","journal-title":"Hepatol. Int."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/j.jhep.2018.05.036","article-title":"Modeling NAFLD Disease Burden in China, France, Germany, Italy, Japan, Spain, United Kingdom, and United States for the Period 2016\u20132030","volume":"69","author":"Estes","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.jhep.2021.02.034","article-title":"Prospective Evaluation of the Prevalence of Non-alcoholic Fatty Liver Disease and Steatohepatitis in a Large Middle-Aged US Cohort","volume":"75","author":"Harrison","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1002\/hep4.1915","article-title":"Nonalcoholic Steatohepatitis Is the Most Common Indication for Liver Transplantation Among the Elderly: Data from the United States Scientific Registry of Transplant Recipients","volume":"6","author":"Stepanova","year":"2022","journal-title":"Hepatol. Commun."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"100219","DOI":"10.1016\/j.jhepr.2020.100219","article-title":"Case-Finding Strategies in Non-alcoholic Fatty Liver Disease","volume":"3","author":"Boursier","year":"2021","journal-title":"JHEP Rep."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1111\/hepr.13605","article-title":"A Novel Rapid Immunoassay of Serum Type IV Collagen 7S for the Diagnosis of Fibrosis Stage of Nonalcoholic Fatty Liver Diseases","volume":"51","author":"Shima","year":"2021","journal-title":"Hepatol. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1002\/hep.21984","article-title":"Noninvasive Markers of Fibrosis in Nonalcoholic Fatty Liver Disease: Validating the European Liver Fibrosis Panel and Exploring Simple Markers","volume":"47","author":"Guha","year":"2008","journal-title":"Hepatology"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Birch-Machin, I., Gao, S., Huen, D., McGirr, R., White, R.A., and Russell, S. (2005). Genomic Analysis of Heat-Shock Factor Targets in Drosophila. Genome Biol., 6.","DOI":"10.1186\/gb-2005-6-7-r63"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"10582","DOI":"10.1038\/s41598-020-67471-y","article-title":"Wisteria floribunda Agglutinin-Positive Mac-2-binding Protein as a Diagnostic Biomarker in Liver Cirrhosis: An Updated Meta-analysis","volume":"10","author":"Feng","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/hep.26030","article-title":"Validation of terminal peptide of procollagen III for the detection and assessment of nonalcoholic steatohepatitis in patients with nonalcoholic fatty liver disease","volume":"57","author":"Tanwar","year":"2013","journal-title":"Hepatology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1002\/hep4.1411","article-title":"Impact of Implementing a \u201cFIB-4 First\u201d Strategy on a Pathway for Patients with NAFLD Referred from Primary Care","volume":"3","author":"Davyduke","year":"2019","journal-title":"Hepatol. Commun."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Sumida, Y., Yoneda, M., Hyogo, H., Itoh, Y., Ono, M., Fujii, H., Eguchi, Y., Suzuki, Y., Aoki, N., and Kanemasa, K. (2012). Validation of the FIB4 Index in a Japanese Nonalcoholic Fatty Liver Disease Population. BMC Gastroenterol., 12.","DOI":"10.1186\/1471-230X-12-2"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/hep.21496","article-title":"The NAFLD Fibrosis Score: A Noninvasive System That Identifies Liver Fibrosis in Patients with NAFLD","volume":"45","author":"Angulo","year":"2007","journal-title":"Hepatology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.jceh.2023.01.016","article-title":"Comparison of Guidelines for the Screening, Diagnosis, and Noninvasive Assessment of Nonalcoholic Fatty Liver Disease","volume":"13","author":"Chow","year":"2023","journal-title":"J. Clin. Exp. Hepatol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1007\/s00535-011-0436-4","article-title":"Platelet Count for Predicting Fibrosis in Nonalcoholic Fatty Liver Disease","volume":"46","author":"Yoneda","year":"2011","journal-title":"J. Gastroenterol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1136\/gutjnl-2021-324243","article-title":"Diagnostic Accuracy of Non-invasive Tests for Advanced Fibrosis in Patients with NAFLD: An Individual Patient Data Meta-analysis","volume":"71","author":"Lee","year":"2022","journal-title":"Gut"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"2570","DOI":"10.1016\/j.cgh.2019.03.006","article-title":"Optimizing Use of Nonalcoholic Fatty Liver Disease Fibrosis Score, fibrosis-4 Score, and Liver Stiffness Measurement to Identify Patients with Advanced Fibrosis","volume":"17","author":"Chan","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/S2468-1253(23)00141-3","article-title":"Performance of Non-invasive Tests and Histology for the Prediction of Clinical Outcomes in Patients with Nonalcoholic Fatty Liver Disease: An Individual Participant Data Meta-analysis","volume":"8","author":"Lee","year":"2023","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1007\/s00330-015-3949-z","article-title":"Magnetic Resonance Elastography for Staging Liver Fibrosis in Non-alcoholic Fatty Liver Disease: A Diagnostic Accuracy Systematic Review and Individual Participant Data Pooled Analysis","volume":"26","author":"Singh","year":"2016","journal-title":"Eur. Radiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1946","DOI":"10.1136\/gutjnl-2020-322976","article-title":"MRE Combined with FIB-4 (MEFIB) Index in Detection of Candidates for Pharmacological Treatment of NASH-Related Fibrosis","volume":"70","author":"Jung","year":"2021","journal-title":"Gut"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver, Clinical Practice Guideline Panel, and Chair: EASL Governing Board Representative (2021). EASL Clinical Practice Guidelines on Non-invasive Tests for Evaluation of Liver Disease Severity and Prognosis\u20142021 Update. J. Hepatol., 75, 659\u2013689.","DOI":"10.1016\/j.jhep.2021.05.025"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1038\/ajg.2011.327","article-title":"Large-Scale Long-Term Follow-Up Study of Japanese Patients with Non-alcoholic Fatty Liver Disease for the Onset of Hepatocellular Carcinoma","volume":"107","author":"Kawamura","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), and European Association for the Study of Obesity (EASO) (2016). EASL-EASD-EASO Clinical Practice Guidelines for the Management of Non-Alcoholic Fatty Liver Disease. J. Hepatol., 64, 1388\u20131402.","DOI":"10.1016\/j.jhep.2015.11.004"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1111\/j.1572-0241.2004.30444.x","article-title":"The Prevalence of Autoantibodies and Autoimmune Hepatitis in Patients with Nonalcoholic Fatty Liver Disease","volume":"99","author":"Adams","year":"2004","journal-title":"Am. J. Gastroenterol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1007\/s00535-005-1711-z","article-title":"Diagnosing Autoimmune Hepatitis in Nonalcoholic Fatty Liver Disease: Is the International Autoimmune Hepatitis Group Scoring System Useful?","volume":"40","author":"Yatsuji","year":"2005","journal-title":"J. Gastroenterol."},{"key":"ref_69","unstructured":"(2023, August 28). The 59th Annual Meeting of the Japan Society of Hepatology. Available online: https:\/\/site2.convention.co.jp\/jsh59\/nara_sengen\/iryou.html."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"106175","DOI":"10.1016\/j.cct.2020.106175","article-title":"The European NAFLD Registry: A Real-World Longitudinal Cohort Study of Nonalcoholic Fatty Liver Disease","volume":"98","author":"Hardy","year":"2020","journal-title":"Contemp. Clin. Trials"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e1456","DOI":"10.1016\/j.cgh.2021.06.048","article-title":"A Global Survey of Physicians Knowledge About Nonalcoholic Fatty Liver Disease","volume":"20","author":"Younossi","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"100411","DOI":"10.1016\/j.jhepr.2021.100411","article-title":"Real-World Management of Non-alcoholic Steatohepatitis Differs from Clinical Practice Guideline Recommendations and Across Regions","volume":"4","author":"Anstee","year":"2022","journal-title":"JHEP Rep."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/11\/2144\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:14:50Z","timestamp":1760130890000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/11\/2144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,31]]},"references-count":72,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["life13112144"],"URL":"https:\/\/doi.org\/10.3390\/life13112144","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,31]]}}}