Referral Patterns for Patients with Nonalcoholic Fatty Liver Disease

Elias Badal Rashu, Mikkel Parsberg Werge, Liv Eline Hetland, Anders Ellekaer Junker, Majken Karoline Jensen, Lise Lotte Gluud

1 Citation (Scopus)


The incidence of nonalcoholic fatty liver disease (NAFLD) is rapidly increasing. This study evaluates the referral pattern of patients with NAFLD. A cohort study evaluating all patients with NAFLD referred to a single Gastroenterology Department from January 2017 to June 2020. Electronic patient referral letters were reviewed, and patients with NAFLD were diagnosed using standardized tests as part of a prospective cohort study. Predictors of nonalcoholic steatohepatitis (NASH) with significant (≥F2) fibrosis were evaluated in logistic regression analyses. In total, 323 (18.6%) of 1735 patients referred to the Gastro Unit during the study period were diagnosed with NAFLD. Patients were referred from general practitioners (62.5%) or other hospital departments (37.5%). Most referral letters included information suggesting a possible diagnosis of NAFLD (patient history, blood tests, or diagnostic imaging) or used the nonspecific general diagnosis suspected disease (Z.038). Out of 110 patients referred for a liver biopsy, 71 (22%) had NASH with significant fibrosis (F2 n = 39, F3 n = 19, F4 n = 13). Thirty-nine of these patients were referred from the primary sector. A logistic regression analysis (adjusted for age and gender) including all 323 patients showed that type 2 diabetes was the only significant independent predictor of NASH with fibrosis.

Original languageEnglish
Article number404
JournalJournal of Clinical Medicine
Issue number3
Pages (from-to)1-8
Number of pages8
Publication statusPublished - 21 Jan 2021


  • cirrhosis
  • cohort study
  • gastroenterology
  • hepatology
  • metabolic syndrome
  • non-alcoholic steatohepatitis
  • type 2 diabetes
  • Type 2 diabetes
  • Metabolic syndrome
  • Cirrhosis
  • Cohort study
  • Hepatology
  • Gastroenterology
  • Non-alcoholic steatohepatitis


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