MASLD screening with FIB-4
Also known as:
Fatty liver risk stratification
Who to screen, how to read FIB-4 and when to refer.
Written and reviewed by Farhan Tahir, MD · Last reviewed
VIDEO LESSON
Who to screen
• Type 2 diabetes or prediabetes
• Obesity with one or more cardiometabolic risk factors
• Persistently elevated liver enzymes
• Hepatic steatosis on imaging
Pathway
• FIB-4 below 1.3: low risk; repeat in 1 to 3 years
• FIB-4 1.3 or higher: vibration-controlled transient elastography (or ELF test)
• Liver stiffness above about 8 kPa, or FIB-4 above 2.67: hepatology referral
Treatment
Target 7% to 10% weight loss or more. Consider resmetirom or semaglutide for MASH with F2 to F3 fibrosis. Manage cardiovascular risk aggressively.
Key studies and references
Educational content only, written and reviewed by Farhan Tahir, MD. It does not replace individual medical advice. For sudden chest pain, trouble breathing or stroke symptoms, call 911.
AT A GLANCE
Section
Diagnosis & risk
Also known as
Fatty liver risk stratification
Reviewed by
Farhan Tahir, MD
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