Metabolic-associated fatty liver disease: Noninvasive diagnosis and assessment of liver fibrosis

Metabolically associated fatty liver disease as one of the most common liver pathologies in the world, which ranges from simple steatosis to more severe forms such as steatohepatitis, which can progress to liver fibrosis, cirrhosis and hepatocellular carcinoma. The stage of fibrosis in hepatic tissue is associated with an increased risk of overall mortality, cardiovascular disease, hepatocellular carcinoma and extrahepatic malignancies, especially in the elderly, when there is an increased predisposition to metabolic disorders, which may lead to the development of fatty liver dystrophy and progression of fibrosis. Histologic methods of liver examination, including liver biopsies are highly informative, making this method of diagnosing liver pathology crucial in verifying the diagnosis; however, these procedures may have rare but potentially serious complications. In this regard, the relevance of using various non-invasive methods to assess the severity of fibrotic processes in liver tissue, including existing scales and algorithms such as FIB-4 and NAFLD Fibrosis Score, BARD and BAAT scales, APRI index and ultrasound elastography is undeniable. This review study examines the use of modern non-invasive approaches to assess the degree of fibrosis in patients with metabolically associated fatty liver disease, including elderly patients. Thus, as a first step the use of calculated fibrosis indices, such as FIB-4 index, NFS scale, followed, if necessary, by ultrasound diagnostic methods, especially liver elastography, is very relevant.